Rural-Urban Differences in Neuroimmune Biomarkers and Health Status among Women Living with Breast Cancer

Background Because of chronic emotional and psychosocial stressors following breast cancer (BC) treatment, BC survivors are at risk of neuroimmune dysfunction in survivorship. Rural BC survivors experience more health disparities than urban BC survivors. Rural-urban residence as a variable on neuroimmune activity in extended BC survivorship continuum has not been explored. Objective To report the feasibility of studying relationships between neuroimmune activity and perceived health in rural and urban BC survivors. Methods Data from a pilot study of BC survivors (n = 41) were analyzed. Participants were rural (n = 16) and urban (n = 25). Participants completed Medical Outcomes Study Short-Form Version 2 Health Survey questionnaires and provided salivary specimens for analysis of salivary α-Amylase (sAA), cortisol, and interleukin 6 (IL-6). Rural-Urban Commuting Area Codes were used to determine rural or urban residence. Results Differences in immune activity were observed between rural and urban BC survivors (U = 34, P <.05). No rural-urban group differences in neuroendocrine activity were observed. Relationships were observed between perceptions of mental health and sAA (P <.05) in rural BC survivors and between perceptions of mental health and IL-6 (P <.05) in urban BC survivors. Interleukin 6 was positively associated with perceptions of physical health (P <.05) in rural BC survivors. Conclusion Pilot data suggest rural-urban residence may be a factor in relationships between neuroimmune function (ie, sAA and IL-6) and perceived health status, particularly social functioning in women with BC. Additional studies with powered designs are indicated. Implications for Practice Although evidence is limited, data support the feasibility of studying relationships between sAA and IL-6 and perceptions of health in women with BC.