Everyday discrimination and telomere length in a multiethnic cohort of breast cancer survivors

ABSTRACT

Objectives: Racial/ethnic minority women have disproportionately lower breast cancer survival rates compared to white women. As minorities in the US are exposed to higher levels of discrimination, and exposure to discrimination has been associated with shorter telomere lengths (TLs), we investigated the association between perceived everyday discrimination and TL in a multiethnic sample of breast cancer survivors.

Design: We examined a cohort of 58 breast cancer survivors who participated in a pilot study to investigate biological stress. Participants were drawn from the Equality in Breast Cancer Care (EBCC) study and were asked to provide saliva samples for DNA extraction. Ordinary least squares linear regression was used to derive regression coefficients (β) and 95% confidence intervals (CI).

Results: Higher levels of everyday discrimination were associated with longer TLs (e^β = 1.04, CI: 1.01–1.07), adjusting for age, race/ethnicity, breast cancer stage, and breast cancer subtype. Luminal B subtypes were associated with longer telomeres relative to luminal A, while African Americans were less likely than Whites to have longer telomeres.

Conclusions: Further research, particularly longitudinal studies, is needed to understand how discrimination, and other social stressors, impact biological stress and health outcomes.

KEYWORDS:

• Breast cancer
• discrimination
• telomere length

Acknowledgements

The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute, Cancer Registry of Greater California. The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Department of Defense Breast Cancer Research Program (W81XWH-07-1-0486, PI: Scarlett Lin Gomez); the Minority Training Program in Cancer Control Research (PI: Rena Pasick); the National Institute of Health Common Fund (UL GM118985, PI: Leticia Marquez-Magana), a fellowship grant from the National Institute on Aging, NIH, awarded to UCSF (P30AG015272, PI: Julio Ramirez); and the International Fellowship from the American Association of University Women (May Elmofty).