The role of body mass index at diagnosis of colorectal cancer on Black-White disparities in survival: a density regression mediation approach

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dc.catalogadorgjm
dc.contributor.authorDevick, Katrina L.
dc.contributor.authorValeri, Linda
dc.contributor.authorChen, Jarvis
dc.contributor.authorJara Vallejos, Alejandro Antonio
dc.contributor.authorBind, Marie-Abele
dc.contributor.authorCoull, Brent A.
dc.date.accessioned2024-06-26T20:35:29Z
dc.date.available2024-06-26T20:35:29Z
dc.date.issued2022
dc.description.abstractThe study of racial/ethnic inequalities in health is important to reduce the uneven burden of disease. In the case of colorectal cancer (CRC), disparities in survival among non-Hispanic Whites and Blacks are well documented, and mechanisms leading to these disparities need to be studied formally. It has also been established that body mass index (BMI) is a risk factor for developing CRC, and recent literature shows BMI at diagnosis of CRC is associated with survival. Since BMI varies by racial/ethnic group, a question that arises is whether differences in BMI are partially responsible for observed racial/ethnic disparities in survival for CRC patients. This article presents new methodology to quantify the impact of the hypothetical intervention that matches the BMI distribution in the Black population to a potentially complex distributional form observed in the White population on racial/ethnic disparities in survival. Our density mediation approach can be utilized to estimate natural direct and indirect effects in the general causal mediation setting under stronger assumptions. We perform a simulation study that shows our proposed Bayesian density regression approach performs as well as or better than current methodology allowing for a shift in the mean of the distribution only, and that standard practice of categorizing BMI leads to large biases when BMI is a mediator variable. When applied to motivating data from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, our approach suggests the proposed intervention is potentially beneficial for elderly and low-income Black patients, yet harmful for young or high-income Black populations.
dc.fuente.origenORCID
dc.identifier.doi10.1093/biostatistics/kxaa034
dc.identifier.eissn1468-4357
dc.identifier.issn1465-4644
dc.identifier.urihttps://doi.org/10.1093/biostatistics/kxaa034
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/86875
dc.identifier.wosidWOS:000782481000007
dc.information.autorucFacultad de Matemáticas; Jara Vallejos, Alejandro Antonio; 0000-0002-2282-353X; 127927
dc.issue.numero2
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final466
dc.pagina.inicio449
dc.rightsacceso restringido
dc.subjectAccelerated failure time model
dc.subjectCancer health disparities
dc.subjectCausal inference
dc.subjectDependent Dirichlet process
dc.subjectNonparametric Bayesian
dc.subjectStochastic intervention
dc.titleThe role of body mass index at diagnosis of colorectal cancer on Black-White disparities in survival: a density regression mediation approach
dc.typeartículo
dc.volumen23
sipa.codpersvinculados127927
sipa.trazabilidadORCID;2024-06-24
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