Neighborhood deprivation and risk of mortality among men with prostate cancer: Findings from a long‐term follow‐up study

Abstract

Background: The overall survival rate of prostate cancer (PCa) has improved over the past decades. However, huge socioeconomic and racial disparities in overall and prostate cancer-specific mortality exist. The neighborhood-level factors including socioeconomic disadvantage and lack of access to care may contribute to disparities in cancer mortality. This study examines the impact of neighborhood deprivation on mortality among PCa survivors.Methods: North Carolina-Louisiana Prostate Cancer Project (PCaP) data were used.A total of 2113 men, 1046 AA and 1067 EA, with PCa were included in the analysis.Neighborhood deprivation was measured by the Area Deprivation Index (ADI) at the census block group level using data from the US Census Bureau. Quintiles of ADI were created. Cox proportional hazards and competing risk models with mixed effects were performed to estimate the effect of neighborhood deprivation on

Higher area deprivation index is associated with poorer local control and overall survival in non‐metastatic nasopharyngeal carcinoma

“…After adjusting for known confounders including comorbidities and cancer stage, higher ADI remained associated with worse local control and overall survival in our cohort, suggesting that higher ADI was independently associated with poorer oncologic outcomes. These findings, to our knowledge, have not been reported previously for NPC, and are consistent with previous studies that have demonstrated the association of low SES with worse outcomes in other cancers such as oral cavity, breast, colorectal, prostate, and lung cancers 9–11,14,15 . Our results contribute to the growing body of literature highlighting the importance of addressing disparities in cancer outcomes related to SES and neighborhood disadvantage.…”

“…The AJCC 8th edition stage distribution was as follows: 30 patients (6.0%) were stage I; 81 (16.1%) were stage II; 189 (37.6%) were stage III; and 203 (40.4%) were stage IVA. Patients from higher ADI neighborhoods 6–10 were more likely to present with advanced‐stage disease (AJCC stage III/IVA) compared to patients with low ADI, 1–5 at 87% versus 76% ( p = 0.03).…”

“…Despite these overall advancements, disparities in NPC outcomes persist, potentially influenced by factors such as socioeconomic status (SES) and neighborhood disadvantage, 7 which may influence access to advanced technologies and optimal multidisciplinary management. SES has been linked to cancer outcomes in numerous studies, which suggest that lower SES and neighborhood disadvantage are associated with worse survival, increased disease burden, and reduced access to optimal cancer care in breast, 8 colorectal, 9 prostate, 10 and lung cancers 11 …”

Association of Neighborhood Deprivation With Prostate Cancer and Immune Markers in African American and European American Men

“…Few of the previous studies 25,26 that investigated neighborhood deprivation and prostate cancer had the diversity of our cohort. Consistent with these and other studies, 15,27 increased neighborhood deprivation tends to be associated with metastatic and lethal prostate cancer rather than the localized disease.…”

“…37,38 Furthermore, we could not examine whether census tract characteristics were associated with individual-level characteristics using our survey. Because we lack participants' addresses over time, we were unable to examine longitudinal changes, time-varying associations, changes in participant mobility, or the role of deprivation at other known important JAMA Network Open | Equity, Diversity, and Inclusion neighborhood levels (eg, block 26 or zip code 39 ). Furthermore, our study lacks data on prostate cancer screening among participants, which is a factor associated with a prostate cancer diagnosis; therefore, we were not able to adjust for this potential confounder.…”