Document Type
Article
Abstract
Background The overall survival rate of prostate cancer (PCa) has improved over the past decades. However, huge socioeconomic and racial disparities in overall and prostate cancer-specific mortality exist. The neighborhood-level factors including socioeconomic disadvantage and lack of access to care may contribute to disparities in cancer mortality. This study examines the impact of neighborhood deprivation on mortality among PCa survivors. Methods North Carolina–Louisiana Prostate Cancer Project (PCaP) data were used. A total of 2113 men, 1046 AA and 1067 EA, with PCa were included in the analysis. Neighborhood deprivation was measured by the Area Deprivation Index (ADI) at the census block group level using data from the US Census Bureau. Quintiles of ADI were created. Cox proportional hazards and competing risk models with mixed effects were performed to estimate the effect of neighborhood deprivation on all-cause and PCa-specific mortality adjusted for age, race, study site, insurance status, and comorbidities. Results Participants living in the most deprived neighborhoods had an increased risk for all-cause mortality (quintiles 4 + 5: adjusted hazard ratio [aHR] = 1.51, 95% confidence interval [CI] = 1.16–1.96) compared to those in the least deprived (quintile 1) neighborhoods. The risk of prostate cancer-specific mortality was also higher among those living in the deprived neighborhoods (quintiles 4 + 5: aHR = 1.90, 95% CI = 1.10–3.50) than those in the least deprived neighborhood. Conclusions The findings suggest neighborhood-level resources or health interventions are essential to improve survival among men with PCa. Additional research should focus on the mechanisms of how the neighborhood environment affects mortality.
Digital Object Identifier (DOI)
Publication Info
Published in The Prostate, Volume 82, Issue 7, 2022.
Rights
© 2022 The Authors. The Prostate published by Wiley Periodicals LLC This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
APA Citation
K. C., M., Oral, E., Rung, A. L., Trapido, E. J., Rozek, L. S., Fontham, E. T. H., Bensen, J. T., Farnan, L., Steck, S. E., Song, L., Mohler, J. L., & Peters, E. S. (2022). Neighborhood deprivation and risk of mortality among men with prostate cancer: Findings from a long‐term follow‐up study. The Prostate, 82(7), 783–792. https://doi.org/10.1002/pros.24320