Association of area of deprivation index with prostate cancer incidence and lethality over a contemporary North American cohort
Recommended Citation
Finati M, Cirulli GO, Chiarelli G, Stephens A, Davis M, Tinsley S, Butaney M, Arora S, Morrison C, Sood A, Buffi NM, Lughezzani G, Salonia A, Briganti A, Montorsi F, Bettocchi C, Carrieri G, Rogers CG, Abdollah F. Association of area of deprivation index with prostate cancer incidence and lethality over a contemporary North American cohort. Eur Urol 2024; 85:S53-S53.
Document Type
Conference Proceeding
Publication Date
3-1-2024
Publication Title
Eur Urol
Abstract
Introduction & Objectives: Increasing evidence indicate that poor socioeconomic status and residence in underprivileged areas contribute to disparities in prostate cancer (PCa) outcomes. While comprehensively assessing the impact of these factors might be might be intricate, the Area of Deprivation Index (ADI) could offer a distinctive and valuable metric for these considerations. Our study examined the impact of ADI on Prostate Cancer (PCa) incidence and lethality over a contemporary North American population. Materials & Methods: Our institutional database included electronic medical records for all men who received at least one PSA test within Henry Ford Health (HFH), between 1995 and 2019. An ADI score were assigned to each patients based on their residential census block group, ranked as a percentile of deprivation relative to the national level. All patients were further categorized into ADI quartile, where the highest quartile (Q4: 75-100) represented individuals with the most disadvantageous socio-economic status. The main outcomes were PCa incidence and lethal PCa, defined as any metastatic PCa or death due to PCa occurred within our cohort. Cumulative incidence curves were used to depict PCa incidence and lethality, after stratifying patients into sub-cohorts based on ADI quartile. Multivariable Fine-Gray regression examined the impact of ADI quartiles on PCa incidence and lethality, after adjusting for all available confounders. Results: A total of 148,892 patients were included, with a median follow-up f of 8.8 (5-17) years. When patients were categorized based on their ADI quartile, the 20-years PCa incidence rates were 9.1%, 8.4%, 7.7% and 8.5%% for the first, second, third and fourth quartile respectively. For the same quartile categories, the 20-years lethal PCa rates were 1.3%, 0.90%, 1.0% and 1.7%. At multivariable analysis, both the third (HR: 0.01, 95% IC: 0'85-0.97, p=0.007) and the fourth quartile (HR: 0.83, 95% IC: 0.77-0.88, p=0.007) had a lower risk of being diagnosed with PCa, when compared with patients in the lowest ADI quartile. On the other side, ADI did not result an independent predictor for lethal PCa. Of note, Non-Hispanic black patients had almost 2-fold the risk both for PCa incidence and lethality, when compared with Non- Hispanic White patients (all p<0.001). Conclusions: Our study is the first to evaluate the role of ADI in predicting PCa incidence and lethality in a contemporary North American cohort. Patients from less disadvantaged areas were more likely diagnosed with PCa, while those from the most deprived areas showed increased lethal PCa rates, though not reaching the conventional significance at multivariable analysis. Notably, race emerged as an independent predictor for both lethal PCa and its incidence, regardless of any socioeconomic and deprivation influences.
Volume
85
First Page
S53
Last Page
S53
