Association of race and area of deprivation index with prostate cancer incidence and lethality: results from a contemporary North American cohort

Authors

Marco Finati, Henry Ford HealthFollow
Alex Stephens, Henry Ford HealthFollow
Giuseppe O. Cirulli, Henry Ford HealthFollow
Giuseppe Chiarelli, Henry Ford HealthFollow
Shane Tinsley, Henry Ford HealthFollow
Chase Morrison, Henry Ford HealthFollow
Akshay Sood
Nicolò Buffi
Giovanni Lughezzani
Andrea Salonia
Alberto Briganti
Francesco Montorsi
Gian Maria Busetto
Craig G. Rogers, Henry Ford HealthFollow
Giuseppe Carrieri
Firas Abdollah, Henry Ford HealthFollow

Recommended Citation

Finati M, Stephens A, Cirulli GO, Chiarelli G, Tinsley S, Morrison C, Sood A, Buffi N, Lughezzani G, Salonia A, Briganti A, Montorsi F, Busetto GM, Rogers C, Carrieri G, and Abdollah F. Association of Race and Area of Deprivation Index with Prostate Cancer Incidence and Lethality. JNCI Cancer Spectr 2024.

Document Type

Article

Publication Date

11-1-2024

Publication Title

JNCI Cancer Spectr

Abstract

BACKGROUND: Socioeconomic and demographic factors contribute to disparity in prostate cancer (PCa) outcomes. We examined the impact of Area of Deprivation Index (ADI) and race on PCa incidence and lethality in a North American cohort.

METHODS: Our cohort included men who received at least 1 prostate-Specifig Antigen (pSA) test within our Health System (1995-2022). An ADI score was assigned to each patient based on their residential census block, ranked as a percentile of deprivation relative to the national level. Individuals were further categorized into quartiles, where the fourth one (ADI 75-100) represented those living in the most deprived areas. We investigated PCa incidence and lethality, using cumulative incidence estimates and competing-risk regression. An ADI × Race interaction term examined whether the relationship between ADI and outcomes varied based on race.

RESULTS: We included 134,366 patients, 25% of whom were NHB. Median (IQR) follow-up was 8.8 (5-17) years. At multivariate analysis, individuals from the third (ADI 50-74, 95% CI: 0.83-0.95) and the fourth quartile (ADI ≥ 75, 95% CI: 0.75-0.86) showed significant reduced HRs for PCa incidence, when compared with the first quartile (ADI < 25, all p < .001). In contrast to the overall cohort, PCa incidence increased with ADI in NHB men, who were persistently at higher hazard for both PCa incidence and lethality than NHW, across all ADI strata (all p < .001).

CONCLUSIONS: Living in more deprived areas was associated with lower PCa incidence and higher lethal disease rate. Conversely, PCa incidence increased with ADI for NHB, who consistently showed worse outcomes than NHW individuals, regardless of ADI.

Medical Subject Headings

Aged; Humans; Male; Middle Aged; Black or African American; Cohort Studies; Health Status Disparities; Hispanic or Latino; Incidence; North America; Prostate-Specific Antigen; Prostatic Neoplasms; Socioeconomic Factors; United States; White

PubMed ID

39576690

ePublication

ePub ahead of print

Volume

8

Issue

6