Impact of Contextual Factors on Prostate Cancer Risk and Outcomes
Final rept. 1 Jul 2010-31 Mar 2014
CANCER PREVENTION INST OF CALIFORNIA FREMONT
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The primary goal of this project was to address the role of contextual factors on prostate cancer risk and survival by pooling data from two prostate cancer case-control studies and geospatial data on social and built environment contextual factors. The results showed that neighborhood socioeconomic status SES accounted for disparities in survivalmortality between Blacks and non-Hispanic Whites. Patient s education only partially accounted for the survival disparity. Neighborhood SES was itself independently associated with survivalmortality after prostate cancer diagnosis. The results also showed more than two-fold increased risk of localized and advanced disease associated with increasing levels of neighborhood SES. For localized disease, this association was largely explained by prostate cancer risk factors as well as certain neighborhood characteristics, specifically population density, crowding, and residential mobility. Neighborhoods that are more dense more per capita residents, have more crowded households household occupants, and have less population mobility are associated with lower prostate cancer risk. For advanced disease, the association with neighborhood SES was not explained by any available individual or neighborhood factors. These results indicate that additional research targeted to understanding the factors and mechanisms underpinning the neighborhood socioeconomic status associations with risk and survival, may help inform future interventions to ameliorate disparities particularly higher risk and mortality of disease among Blacks.
- Medicine and Medical Research