Abstract 4925: Social determinant predictors of lung cancer incidence in diverse urban populations
Authors: Vijeth Narra, Alex Krule, Abdul J. Zakkar, Mason Burrage-Burton, Farah Yousef, Vijayakrishna Gadi, Frank Weinberg, Mark Korpics, Yamilé Molina, Sage J. Kim, Margaret Geise-Wright, Zhengjia Chen, Elisabeta Marai, Ryan H. Nguyen, Ameen A. Salahudeen
Journal: Cancer Research (2025)

Abstract Background: Lung cancer is the leading cause of cancer-related mortality globally. While screening and predictive analytics provide insights into its pathogenesis, the role of social determinants of health (SDOH), particularly in urban U.S. populations, is unexplored at the individual level. This study examines associations between SDOH factors and lung cancer within Chicago. Methods: An IRB-approved protocol was used to build a retrospective cohort of 11, 154 patients (60% African American [AA], 30% White, 10% Other) from the University of Illinois Health System. Inclusion criteria followed the U.S. Preventive Services Task Force guidelines. Twenty-three zip code-level SDOH indices (measured between 2016-2023) and patient data were analyzed using statistical analyses, including hypergeometric testing and principle component analysis. Benjamini-Hochberg correction was used for multiple hypothesis testing. Results: Non-cancer patients had less green space access than lung cancer patients (meandiff=0.93, P=0.048). Lung cancer incidence correlated with increased fine particulate matter (PM2.5) levels (meandiff=0.03, P=0.030). Men with lung cancer had lower PM2.5 exposure (meandiff=0.06, P=0.007), poverty rates (meandiff=1.73, P=0.003), and Medicaid coverage (meandiff=1.89, P=0.017) compared to women, suggesting increased sensitivity to these factors. Patients with low/normal BMI and lung cancer experienced higher food insecurity (meandiff=0.64, P=0.019) compared to those with high BMI. Among non-cancer patients, low/normal BMI individuals showed lower area deprivation scores (meandiff=1.38, P=0.001) but higher lack of vehicle access (meandiff=1.34, P=4.202e-7), lifetime inhalation cancer risks (meandiff=0.29, P=0.003), and respiratory hazards (meandiff=0.01, P=0.003) compared to high BMI individuals. AA patients experienced disproportionately adverse SDOH impacts, regardless of cancer status (P&amp;lt;0.001). AA lung cancer patients had higher PM2.5 exposure than non-cancer AA patients (meandiff=0.03, P=0.016). AA women without lung cancer had higher PM2.5 exposure (meandiff=0.02, P=0.010), green space access (meandiff=1.02, P=0.001), and respiratory hazard risks (meandiff=0.004, P=0.028), but lower high school graduation rates (meandiff=0.401, P=0.046) compared to AA men. Conclusions: Our preliminary findings highlight the need to integrate environmental and social variables, such as PM2.5 and SDOH, into lung cancer risk frameworks.. Additional studies are also merited to investigate a mechanistic link between SDOH factors, PM2.5, and lung cancer disparities. Limitations: Patient zip codes may not reflect long-term residential histories. Minimal PM2.5 variability at the zip code level warrants higher-resolution mapping. Racial comparisons were limited to AA and White patients, prompting broader demographic inclusion in future studies. Citation Format: Vijeth Narra, Alex Krule, Abdul J. Zakkar, Mason Burrage-Burton, Farah Yousef, Vijayakrishna Gadi, Frank Weinberg, Mark Korpics, Yamilé Molina, Sage J. Kim, Margaret Geise-Wright, Zhengjia Chen, Elisabeta Marai, Ryan H. Nguyen, Ameen A. Salahudeen. Social determinant predictors of lung cancer incidence in diverse urban populations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4925.