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.fechaingreso.objetodigital2024-11-14
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.subject.ods03 Good health and well-being
dc.subject.ods02 Zero hunger
dc.subject.odspa03 Salud y bienestar
dc.subject.odspa02 Hambre cero
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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