Racial disparity and socioeconomic status in association with survival in older men with local/regional stage prostate carcinoma

Du, Xianglin L.; Fang, Shenying; Coker, Ann L.; Sanderson, Maureen; Aragaki, Corrine; Cormier, Janice N.; Xing, Yan; Gor, Beverly; Chan, Wenyaw

doi:10.1002/cncr.21732

Cited by 219 publications

(204 citation statements)

References 40 publications

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“…24 Multilevel studies from the US demonstrated the importance of income inequality for mortality. 16,17,25 In contrast, in Nova Scotia in Canada, a country with lower income inequality than the US, neighborhood socioeconomic characteristics were not significantly associated with mortality. 26 In the UK, previous studies have described neighborhood effects on health.…”

Section: Discussionmentioning

confidence: 95%

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Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden

Sundquist

2011

Prostate Cancer Prostatic Dis

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in patients aged 25-74 years (a total of 73 159 patients). Multilevel logistic regression analyses were performed with individual-level characteristics at the first level and level of neighborhood deprivation at the second level. RESULTS:The age-standardized prostate cancer mortality rate was 1.5 times higher in men living in high-deprivation neighborhoods than in those living in the most affluent neighborhoods. Mortality rates were also associated with certain individual-level characteristics, that is, age, marital status, family income, educational attainment, immigration status, urban/rural status, mobility and comorbidity. For example, there was a strong relationship between prostate cancer mortality and being unmarried, having a low income or educational attainment, and hospitalization for chronic obstructive pulmonary disease. In the full model, the risk of prostate cancer mortality was 25% higher in men living in the most deprived neighborhoods than in those living in the most affluent neighborhoods.CONCLUSIONS: High level of neighborhood deprivation independently predicts prostate cancer mortality. This raises important clinical and public health concerns. Both individual-and neighborhood-level approaches are important in healthcare policies.

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Section: Discussionmentioning

confidence: 95%

“…[10][11][12][13][14] However, only a few studies have documented the effects of neighborhood-level SES on prostate cancer risk. [15][16][17] To the best of our knowledge, no study to date has simultaneously analyzed the effect of neighborhood-level SES on prostate cancer mortality, after adjusting for individual-level characteristics.…”

Section: Introductionmentioning

confidence: 99%

Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden

Sundquist

2011

Prostate Cancer Prostatic Dis

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“…In terms of SES subgroups, the survival significantly increased in the high‐poverty group, and the gap among SES subgroups kept narrowing over time in the three decades. SES, including household income, insurance status, education, and poverty, is increasing critical for disease prognosis with timely and more effective treatment resources in several cancers 27, 28. Compared to patients with low poverty, high‐poverty patients were more likely to reside in counties in which usually were lower health insurance coverage, diminished access to health care providers and fewer oncologist, all of which were related to a delay in diagnosis and higher risk of early death.…”

Section: Discussionmentioning

confidence: 99%

Increased survival of patients aged 0‐29 years with osteosarcoma: A period analysis, 1984‐2013

Sun

et al. 2018

Cancer Medicine

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PurposeOsteosarcoma is the most common primary malignancy of bone, and typically occurs among children and adolescence. This study aims to evaluate treatment outcomes among children, adolescents and young adults with osteosarcoma over the three decades by the changes in the long‐term relative survival.MethodsOsteosarcoma incidence and relative survival data from Surveillance, Epidemiology, and End Results (SEER) registries during 1984‐2013 were analyzed. The survival differences over three decades, age, sex, race, and socioeconomic status (SES) were assessed by comparing Kaplan‐Meier curves.ResultsThe overall incidence of osteosarcoma kept relatively stable with 0.4 per 100 000 in the three decades with the peak incidence occurring in the aged 10‐19 group. The 10‐year relative survival rate (RSR) increased from 57.7% to 61.0% in the three decades, with the greatest increase in the aged 0‐9 group from 48.2% to 65.7%. The 10‐year RSR improved from 54.1% to 61.5% in males, and from 62.4% to 63.0% in females, respectively, in the three decades. Furthermore, survival dramatically improved from 30% to 60% in the high‐poverty group over the three decades.ConclusionThis study demonstrated that the overall incidence of osteosarcoma remained stable, with an improvement in survival in the three decades. The improved survival was greater in males than in females in the three decades. Furthermore, the survival significantly increased in high‐poverty group, which was attributed to increasing improved health care system and patients with low finance can also have access to receiving effective and consistent treatment without distinction.

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“…Prostate-specific antigen (PSA) testing has led to earlier PCa detection, resulting in an increased number of men being diagnosed and treated, which, in turn, has reduced the proportion of PCa metastasis and disease-specific mortality. Nevertheless, African American (AA) men are known to suffer a substantial and disproportionate PCa burden, with studies showing higher incidence, more-advanced stages at diagnosis, more aggressive tumors, and poorer outcomes than other racial groups [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Racial Variation in Prostate Cancer Upgrading and Upstaging Among Men with Low-risk Clinical Characteristics

et al. 2015

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Background: African American (AA) men suffer a higher prostate cancer (PCa) burden than other groups. Objective: We aim to determine the impact of race on the risk of upgrading, upstaging, and positive surgical margins (PSM) at radical prostatectomy (RP) among men eligible for active surveillance. Design, setting, and participants: We studied men with low-risk PCa treated with RP at two centers. Low clinical risk was defined by National Comprehensive Cancer Network criteria. Outcome variables were upgrading, upstaging, and PSMs at surgery. Associations between race and the outcomes were evaluated with logistic regression adjusted for age, relationship status, diagnostic prostate-specific antigen level, percentage of positive biopsy cores, surgical approach, year of diagnosis, and clinical site. Results and limitations: Of 9304 men diagnosed with PCa, 4231 were low risk and underwent RP within 1 yr. Men were categorized as AA (n = 273; 6.5%), Caucasian (n = 3771; 89.1%), or other racial/ethnic group (Other; n = 187; 4.4%). AA men had a significantly younger mean age (58.7 yr; standard deviation: AE7.06), and fewer (85%) were married or had a partner. Upgrading (34%) and upstaging (13%) rates did not significantly differ among the groups. The PSM rate was significantly higher in AA men (31%) than in the Caucasian (21%) and Other (20%) groups ( p < 0.01). We found an association between race group and PSM rate ( p < 0.03), with higher odds of PSMs in AA men versus Caucasian men (odds ratio [OR]: 1.64; 95% confidence interval [CI], 1.08-2.47). No statistically significant associations between race and rates of upgrading and upstaging were found. This study was limited by the relatively low proportion of AA men in the cohort. Conclusions: Among clinically low-risk men who underwent RP, AA men had a higher likelihood of PSMs compared with Caucasian men. We did not find statistically significantly different rates of upgrading and upstaging between the race groups. Patient summary: We analyzed two large groups of men with what appeared to be lowrisk prostate cancer based on the initial biopsy findings. The likelihood of finding worse disease (higher grade or stage) at the time of surgery was similar across different racial groups.

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Racial disparity and socioeconomic status in association with survival in older men with local/regional stage prostate carcinoma

Cited by 219 publications

References 40 publications

Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden

Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden

Increased survival of patients aged 0‐29 years with osteosarcoma: A period analysis, 1984‐2013

Racial Variation in Prostate Cancer Upgrading and Upstaging Among Men with Low-risk Clinical Characteristics

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