Abstract 267: Demographic differences in patients diagnosed with breast neoplasms living in Arkansas counties that have a history of a high percentage of crop land
Authors: Penney Rosalind B. , Phelan Bryant , Schrader Amy M. , Moore Page , Kadlubar Susan A. 
Published: May 2015

Abstract
Cancer is the second leading cause of death in Arkansas, and obesity is a significant co-morbidity. Understanding how obesity interacts with environmental exposures to influence cancer rates is critical to the health of Arkansans. Agriculture is the largest industry in Arkansas, and positive associations between BMI, pesticide exposure and breast cancer incidence in pesticide applicators have been reported, possibly due to perturbations in hormones and oxidative stress. The primary goal of the current study is to explore the roles of BMI and county of residence in women with breast neoplasm diagnoses utilizing the UAMS Data Warehouse dataset (a collection of data on patients treated at a University of Arkansas for Medical Sciences facility [1999-2012]). This case-case study identified Arkansas counties with either a high or low percentage of cropland in 1987. Eighteen counties were pair-matched within each group based on population and cancer cases, with 272 and 271 patients residing in high and low percentage of cropland respectively who had malignant breast neoplasm diagnoses. Adjusted odds ratios were calculated using logistic regression. With percentage of cropland (high vs. low) as the response variable and independent variables of race, age and BMI, Caucasians [OR 3.461; CI (1.954, 6.129)] were significantly higher within the low cropland than the high cropland, and age at diagnosis [OR 0.979; (0.963, 0.995)] was significantly lower within the high cropland than the low cropland. When the model was stratified by race (Caucasian and non-Caucasians), age at diagnosis [OR 0.977; CI (0.959, 0.995)] was significantly lower within the high cropland than the low cropland for Caucasians. No significant differences were found among non-Caucasians between high and low of cropland. When the model was stratified by BMI (normal/underweight and overweight/obese), Caucasians [OR 4.222; CI (2.114, 8.436)] were significantly higher within low cropland than the high cropland for overweight/obese patients and age at diagnosis [OR 0.972; CI (0.947, 0.998)] was significantly lower within the high cropland than the low cropland for normal/underweight patients. Within the high cropland population, using race as a response variable, BMI (OR 0.427; CI 0.28, 0.66) was significantly higher and age at diagnosis (OR 1.17; CI 1.04, 1.32) was significantly lower for non-Caucasians. These data demonstrate a difference in breast cancer patients both between high and low cropland counties, and within the high cropland counties in Arkansas. Thus, BMI and environmental exposures could interact to influence breast cancer risk in agricultural communities. With the growing obesity epidemic, understanding how these factors are related are critical in the design of cancer prevention strategies.
Citation Format: Rosalind B. Penney, Bryant Phelan, Amy M. Schrader, Page Moore, Susan A. Kadlubar. Demographic differences in patients diagnosed with breast neoplasms living in Arkansas counties that have a history of a high percentage of crop land. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 267. doi:10.1158/1538-7445.AM2014-267