Title
Socioeconomic status, healthcare density, and risk of prostate cancer among African American and Caucasian men in a large prospective study
PubMed ID
22674292
UMMS Affiliation
Department of Family Medicine and Community Health; Meyers Primary Care Institute
Date
7-1-2012
Document Type
Article
Subjects
Prostatic Neoplasms; Prospective Studies
Disciplines
Community Health and Preventive Medicine | Epidemiology | Male Urogenital Diseases | Neoplasms | Preventative Medicine | Primary Care
Abstract
OBJECTIVES: The purpose of this study was to separately examine the impact of neighborhood socioeconomic deprivation and availability of healthcare resources on prostate cancer risk among African American and Caucasian men.
METHODS: In the large, prospective NIH-AARP Diet and Health Study, we analyzed baseline (1995-1996) data from adult men, aged 50-71 years. Incident prostate cancer cases (n = 22,523; 1,089 among African Americans) were identified through December 2006. Lifestyle and health risk information was ascertained by questionnaires administered at baseline. Area-level socioeconomic indicators were ascertained by linkage to the US Census and the Area Resource File. Multilevel Cox models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs).
RESULTS: A differential effect among African Americans and Caucasians was observed for neighborhood deprivation (p-interaction = 0.04), percent uninsured (p-interaction = 0.02), and urologist density (p-interaction = 0.01). Compared to men living in counties with the highest density of urologists, those with fewer had a substantially increased risk of developing advanced prostate cancer (HR = 2.68, 95 % CI = 1.31, 5.47) among African American.
CONCLUSIONS: Certain socioeconomic indicators were associated with an increased risk of prostate cancer among African American men compared to Caucasians. Minimizing differences in healthcare availability may be a potentially important pathway to minimizing disparities in prostate cancer risk.
Comments
Citation: Cancer Causes Control. 2012 Jul;23(7):1185-91. Epub 2012 May 22. Link to article on publisher's site