Impact of individual and neighborhood factors on socioeconomic disparities in localized and advanced prostate cancer risk

DeRouen, Mindy C.; Schupp, Clayton W.; Yang, Juan; Koo, Jocelyn; Hertz, Andrew; Shariff‐Marco, Salma; Cockburn, Myles; Nelson, David; Ingles, Sue A.; Cheng, Iona; John, Esther M.; Gomez, Scarlett Lin

doi:10.1007/s10552-018-1071-7

Cited by 30 publications

(17 citation statements)

References 40 publications

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“…Previous studies have found that low SES/more deprived neighborhoods are associated with a greater risk of late‐stage and/or high‐grade PCa in both black and white men, and less aggressive treatment . Associations between neighborhood SES and PCa remain, even after adjustments for race/ethnicity . Thus, these findings suggest that neighborhood is independently associated with PCa, perhaps under a chronic stress mechanism, whereby residents from disadvantaged neighborhoods experience constant emotional distress that over time affects cancer initiation and progression .…”

Section: Introductionmentioning

confidence: 66%

“…With current “candidate‐based” variable selection approaches in neighborhood and cancer studies, this is challenging to investigate. Within a single neighborhood and cancer study, the same neighborhood SES factors or domains (ie, poverty, education) often are selected a priori for evaluation within each racial/ethnic group . More specifically, 5 to 100 US Census variables typically are hand‐selected as candidates, and various analytic approaches are used to identify relevant SES domains, reduce the number of variables to study (by removing overlapping and/or highly correlated variables), and/or to develop composite neighborhood SES/deprivation indices that create single summary scores of such items as a neighborhood's overall employment, education, or income .…”

Section: Introductionmentioning

confidence: 99%

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Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

Lynch

Sorice

Tagai

et al. 2020

Cancer

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BACKGROUND: Black men are more likely to die of prostate cancer (PCa) compared with white men. Factors ranging from genetics to neighborhood environment contribute to these disparities. However, unlike genetics, agnostic investigations that identify candidate variables from large-scale data, and that allow for empiric investigations into differential associations between neighborhood and PCa by race/ethnicity, to the authors' knowledge have not been well explored. Thus, herein, the authors built on their previously developed, empiric neighborhood-wide association study (NWAS) in white men and conducted a NWAS in black men to determine whether findings differed by race. METHODS: Pennsylvania Cancer Registry data were linked to US Census data. For the NWAS in non-Hispanic black men, the authors evaluated the association between 14,663 neighborhood census variables and advanced PCa (11 high-stage and/or high-grade cases and 8632 low-stage and/or low-grade cases), adjusting for age, diagnosis year, spatial correlation, and multiple testing. Odds ratios and 95% credible intervals were reported. Replication of NWAS findings across black and white races was assessed using Bayesian mixed effects models. RESULTS: Five variables related to housing (3 variables), education (1 variable), and employment and/or transportation (1 variable) were found to be significantly associated with advanced PCa in black men compared with 17 socioeconomic variables (mostly related to poverty and/or income) in white men. The top hit in black men was related to crowding in renter-occupied housing (odds ratio, 1.10; 95% credible interval, 1.001-1.12). Nine of 22 NWAS hits (4 of 5 hits in black men) were replicated across racial/ethnic groups. CONCLUSIONS: Different neighborhood variables, or "candidates," were identified across race-specific NWASs. These findings and empiric approaches warrant additional study and may inform PCa racial disparities, particularly future gene-environment studies aimed at identifying patients and/or communities at risk of advanced PCa.

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Section: Introductionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

Lynch

Sorice

Tagai

et al. 2020

Cancer

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“…Given that ATC is one of the most aggressive human malignancies, it is vital to identify relevant prognostic factors, both clinical and non-clinical (26,27). In recent decades, many studies about socioeconomic factors' effect on disease and medical care have been conducted (28)(29)(30). Considering these facts, our study analyzed the impact of common SEFs on advanced ATC prognosis, and demonstrated that regional family income level is independently associated with OS and CSS in stage IV ATC.…”

Section: Discussionmentioning

confidence: 93%

County Median Family Income Is an Independent Prognostic Factor for Stage IV Anaplastic Thyroid Cancer

Mao

et al. 2019

Anticancer Res

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Background/Aim: Advanced anaplastic thyroid cancer (ATC) is a rare, but highly aggressive malignancy, and its prognostic factors need to be further explored. We examined socioeconomic factors' predictive effect for survival performance in stage IV ATC patients. Materials and Methods: Using the Surveillance, Epidemiology, and End Results database, we collected 1,048 cases with stage IV anaplastic thyroid cancer (ATC) from 2004 to 2015. Demographic, clinical, and socioeconomic factors were evaluated using univariate and multivariate analyses. Results: Median family income showed a significant effect on overall survival (OS) and cancer-specific survival (CSS) in univariate analysis. Median family income level was found to be an independent prognostic factor for OS after multivariate adjustment Multivariate analysis for CSS showed similar results. Conclusion: Family income level is an independent prognostic factor for stage IV ATC.Anaplastic thyroid cancer (ATC) is rare, but is one of the most lethal neoplasms in humans (1). Arising in the thyroid follicular epithelium, ATC is composed of undifferentiated cells that lack classic features of the thyroid gland and is, thus, also known as undifferentiated thyroid cancer (2). While it comprises of just 2% of all thyroid cancers, it accounts for up to 50% of mortality associated with thyroid cancer (3). Death often follows only a few months following diagnosis -median survival is 5 months (4), and less than 20% of patients survive for more than one year (5). This grim prognosis of ACT is likely due to the combination of occult symptoms, difficult diagnosis, and poor response to therapy (6, 7).Considering the exceptionally aggressive nature of ATC, it is essential to identify its prognostic factors. Previous studies have confirmed that clinical factors including tumor size, presence of acute symptoms, extent of disease, leukocytosis, and treatment type impact survival (8-14). Recent studies have suggested that socioeconomic factors (SEF); such as marital status, insurance type, regional prosperity and educational attainment may also be important to consider as part of the prognosis of cancer disease (15)(16)(17)(18)(19)(20). Studies on the importance of SEF in thyroid cancer, however, have so far mainly addressed well differentiated thyroid cancers rather than ATC (21)(22)(23)(24).In this study, we examined the impact of several SEFs, as well as traditional clinical factors on the survival of patients with stage IV ATC. Our aim was to further understand the role of common SEFs in the prognosis of advanced ATC and find more evidence for improving the quality of public health studies and associated policies. Materials and MethodsData source. All data was extracted from the 2017 Surveillance, Epidemiology, and the End Results (SEER) database of the National Cancer Institute using the SEER*Stat 8.3.5 software.Since 1973, the SEER program has published epidemiological information on cancer statistics in the United States, covering approximately 28% of the population (25). This ...

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“…These results are encouraging given the multitude of studies demonstrating sociodemographic disparities in PCa outcomes. [18][19][20][21] Previous work from population-based data in the United States noted that men with any insurance were much less likely than men without any insurance to present with metastatic disease at the time of PCa diagnosis. 21 Additional prior work from the NCDB demonstrated that men aged <65 years who had Medicaid insurance were more likely to present with metastatic disease compared those who had private insurance.…”

Section: Discussionmentioning

confidence: 99%

Changes in prostate‐specific antigen at the time of prostate cancer diagnosis after Medicaid expansion in young men

Weiner

Desai

et al. 2020

Cancer

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BACKGROUND:The objective of this study was to determine the effect of Medicaid expansion under the Patient Protection and Affordable Care Act (January 1, 2014) on the epidemiology of high-risk prostate-specific antigen (PSA) levels (≥20 ng/mL) at the time of prostate cancer (PCa) diagnosis. The authors hypothesized that better access to care would result in a reduction of high-risk features at diagnosis. METHODS: A retrospective cohort study was performed of 122,324 men aged <65 years who were diagnosed with PCa within the National Cancer Database. Difference-in-difference (DID) analyses adjusting for sociodemographic variables using linear regression compared PSA levels at diagnosis before expansion (2012)(2013) and after expansion (2015)(2016) between men residing in states that did or did not expand Medicaid. RESULTS: From 2012 to 2016, the proportion of men with PSA levels ≥20 ng/mL increased (from 18.9% to 19.8%) in nonexpansion states and decreased (from 19.9% to 18.2%) in expansion states. Compared with men in nonexpansion states, men in expansion states experienced a decline in PSA ≥20 ng/mL (DID, −2.33%; 95% CI, −3.21% to −1.44%; P < .001). Accordingly, the proportion of men presenting with high-risk disease decreased in expansion states relative to nonexpansion states (DID, −1.25%; 95% CI, −2.26% to 0.25%; P = .015). A similar statistically significant decrease in PSA levels ≥20 ng/mL was noted among black men (DID, −3.11%; 95% CI, −5.25% to 0.96%; P = .005). CONCLUSIONS: In Medicaid expansion states, there was an associated decrease in the proportion of young men presenting with PSA ≥20 ng/mL at the time of PCa diagnosis. These results suggest that Medicaid expansion improved access to PCa screening. Longer term data should assess oncologic outcomes.

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Impact of individual and neighborhood factors on socioeconomic disparities in localized and advanced prostate cancer risk

Cited by 30 publications

References 40 publications

Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

County Median Family Income Is an Independent Prognostic Factor for Stage IV Anaplastic Thyroid Cancer

Changes in prostate‐specific antigen at the time of prostate cancer diagnosis after Medicaid expansion in young men

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