Neighborhood Disadvantage and Prostate Tumor Aggressiveness among African American and European American Men
Studies have identified associations between neighborhood disadvantage (ND), which is more likely to affect African American (AA) individuals, and aggressive prostate cancer. Thus, ND may contribute to prostate cancer disparities. However, it is unknown what ND components drive aggressive disease an...
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| Vydáno v: | Cancer epidemiology, biomarkers & prevention Ročník 33; číslo 10; s. 1318 |
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| Hlavní autoři: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
02.10.2024
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| ISSN: | 1538-7755, 1538-7755 |
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| Abstract | Studies have identified associations between neighborhood disadvantage (ND), which is more likely to affect African American (AA) individuals, and aggressive prostate cancer. Thus, ND may contribute to prostate cancer disparities. However, it is unknown what ND components drive aggressive disease and whether associations vary by race.
We evaluated associations between aggressive prostate cancer and four ND metrics-Area Deprivation Index (ADI), validated Bayesian Neighborhood Deprivation Index (NDI), racial isolation (RI) index, and historical redlining, and whether these factors interacted with race, among men with prostate cancer treated at the University of Maryland Greenebaum Comprehensive Cancer Center (2004-2021).
We included 1,458 men (698 European American and 760 AA). AA men were more likely to experience ND. In adjusted models, the ADI, RI, and redlining were significantly associated with aggressive versus nonaggressive prostate cancer overall [ADI, OR for one SD increase = 1.14, 95% confidence interval (CI), 1.00-1.30; RI, OR = 1.27, CI, 1.07-1.51; redlining, OR = 1.77; CI, 1.23-2.56] and among AA men. The NDI was associated with aggressive prostate cancer among AA men (OR = 1.32, 95% credible interval: 1.13-1.57); percent in poverty received the largest importance weight. The ADI (P heterogeneity = 0.002) and NDI (exceedance probability heterogeneity = 98.1%) significantly interacted with race, such that associations were significantly stronger for AA men.
We identified novel significant positive associations for racial segregation and historical redlining with aggressive prostate cancer and significant interactions between ND indices and race.
Findings inform specific ND components that are associated with aggressive prostate cancer and suggest the ND effect is stronger for AA men, which has implications for interventions to reduce disparities. |
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| AbstractList | Studies have identified associations between neighborhood disadvantage (ND), which is more likely to affect African American (AA) individuals, and aggressive prostate cancer. Thus, ND may contribute to prostate cancer disparities. However, it is unknown what ND components drive aggressive disease and whether associations vary by race.
We evaluated associations between aggressive prostate cancer and four ND metrics-Area Deprivation Index (ADI), validated Bayesian Neighborhood Deprivation Index (NDI), racial isolation (RI) index, and historical redlining, and whether these factors interacted with race, among men with prostate cancer treated at the University of Maryland Greenebaum Comprehensive Cancer Center (2004-2021).
We included 1,458 men (698 European American and 760 AA). AA men were more likely to experience ND. In adjusted models, the ADI, RI, and redlining were significantly associated with aggressive versus nonaggressive prostate cancer overall [ADI, OR for one SD increase = 1.14, 95% confidence interval (CI), 1.00-1.30; RI, OR = 1.27, CI, 1.07-1.51; redlining, OR = 1.77; CI, 1.23-2.56] and among AA men. The NDI was associated with aggressive prostate cancer among AA men (OR = 1.32, 95% credible interval: 1.13-1.57); percent in poverty received the largest importance weight. The ADI (P heterogeneity = 0.002) and NDI (exceedance probability heterogeneity = 98.1%) significantly interacted with race, such that associations were significantly stronger for AA men.
We identified novel significant positive associations for racial segregation and historical redlining with aggressive prostate cancer and significant interactions between ND indices and race.
Findings inform specific ND components that are associated with aggressive prostate cancer and suggest the ND effect is stronger for AA men, which has implications for interventions to reduce disparities. Studies have identified associations between neighborhood disadvantage (ND), which is more likely to affect African American (AA) individuals, and aggressive prostate cancer. Thus, ND may contribute to prostate cancer disparities. However, it is unknown what ND components drive aggressive disease and whether associations vary by race.BACKGROUNDStudies have identified associations between neighborhood disadvantage (ND), which is more likely to affect African American (AA) individuals, and aggressive prostate cancer. Thus, ND may contribute to prostate cancer disparities. However, it is unknown what ND components drive aggressive disease and whether associations vary by race.We evaluated associations between aggressive prostate cancer and four ND metrics-Area Deprivation Index (ADI), validated Bayesian Neighborhood Deprivation Index (NDI), racial isolation (RI) index, and historical redlining, and whether these factors interacted with race, among men with prostate cancer treated at the University of Maryland Greenebaum Comprehensive Cancer Center (2004-2021).METHODSWe evaluated associations between aggressive prostate cancer and four ND metrics-Area Deprivation Index (ADI), validated Bayesian Neighborhood Deprivation Index (NDI), racial isolation (RI) index, and historical redlining, and whether these factors interacted with race, among men with prostate cancer treated at the University of Maryland Greenebaum Comprehensive Cancer Center (2004-2021).We included 1,458 men (698 European American and 760 AA). AA men were more likely to experience ND. In adjusted models, the ADI, RI, and redlining were significantly associated with aggressive versus nonaggressive prostate cancer overall [ADI, OR for one SD increase = 1.14, 95% confidence interval (CI), 1.00-1.30; RI, OR = 1.27, CI, 1.07-1.51; redlining, OR = 1.77; CI, 1.23-2.56] and among AA men. The NDI was associated with aggressive prostate cancer among AA men (OR = 1.32, 95% credible interval: 1.13-1.57); percent in poverty received the largest importance weight. The ADI (P heterogeneity = 0.002) and NDI (exceedance probability heterogeneity = 98.1%) significantly interacted with race, such that associations were significantly stronger for AA men.RESULTSWe included 1,458 men (698 European American and 760 AA). AA men were more likely to experience ND. In adjusted models, the ADI, RI, and redlining were significantly associated with aggressive versus nonaggressive prostate cancer overall [ADI, OR for one SD increase = 1.14, 95% confidence interval (CI), 1.00-1.30; RI, OR = 1.27, CI, 1.07-1.51; redlining, OR = 1.77; CI, 1.23-2.56] and among AA men. The NDI was associated with aggressive prostate cancer among AA men (OR = 1.32, 95% credible interval: 1.13-1.57); percent in poverty received the largest importance weight. The ADI (P heterogeneity = 0.002) and NDI (exceedance probability heterogeneity = 98.1%) significantly interacted with race, such that associations were significantly stronger for AA men.We identified novel significant positive associations for racial segregation and historical redlining with aggressive prostate cancer and significant interactions between ND indices and race.CONCLUSIONSWe identified novel significant positive associations for racial segregation and historical redlining with aggressive prostate cancer and significant interactions between ND indices and race.Findings inform specific ND components that are associated with aggressive prostate cancer and suggest the ND effect is stronger for AA men, which has implications for interventions to reduce disparities.IMPACTFindings inform specific ND components that are associated with aggressive prostate cancer and suggest the ND effect is stronger for AA men, which has implications for interventions to reduce disparities. |
| Author | Knott, Cheryl L Wimbush, Jessica Onukwugha, Eberechukwu Wheeler, David C Barry, Kathryn Hughes Slade, Jimmie L Butts, Derrick A Hussain, Arif Boyle, Joseph Park, Jong Y Yau, Jessica |
| Author_xml | – sequence: 1 givenname: Joseph orcidid: 0000-0002-1411-5584 surname: Boyle fullname: Boyle, Joseph organization: Massey Comprehensive Cancer Center, Richmond, Virginia – sequence: 2 givenname: Jessica orcidid: 0000-0001-6722-6686 surname: Yau fullname: Yau, Jessica organization: Department of Cellular and Molecular Biomedical Science, University of Maryland School of Medicine, Baltimore, Maryland – sequence: 3 givenname: Jimmie L orcidid: 0000-0002-4421-9691 surname: Slade fullname: Slade, Jimmie L organization: Community Ministry of Prince George's County, Upper Marlboro, Maryland – sequence: 4 givenname: Derrick A orcidid: 0009-0004-8172-2247 surname: Butts fullname: Butts, Derrick A organization: Prostate Health Matters, Washington, District of Columbia – sequence: 5 givenname: Jessica orcidid: 0009-0003-8774-6971 surname: Wimbush fullname: Wimbush, Jessica organization: University of Maryland Greenebaum Comprehensive Cancer Center Tumor Registry, Baltimore, Maryland – sequence: 6 givenname: Jong Y orcidid: 0000-0002-6384-6447 surname: Park fullname: Park, Jong Y organization: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center, Tampa, Florida – sequence: 7 givenname: Arif orcidid: 0000-0001-8485-4406 surname: Hussain fullname: Hussain, Arif organization: Program in Oncology, University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland – sequence: 8 givenname: Eberechukwu orcidid: 0000-0001-8547-1810 surname: Onukwugha fullname: Onukwugha, Eberechukwu organization: Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, Maryland – sequence: 9 givenname: Cheryl L orcidid: 0000-0002-2261-7875 surname: Knott fullname: Knott, Cheryl L organization: Department of Behavioral and Community Health, University of Maryland, College Park, Maryland – sequence: 10 givenname: David C orcidid: 0000-0001-8121-5182 surname: Wheeler fullname: Wheeler, David C organization: Massey Comprehensive Cancer Center, Richmond, Virginia – sequence: 11 givenname: Kathryn Hughes orcidid: 0000-0003-4661-0595 surname: Barry fullname: Barry, Kathryn Hughes organization: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland |
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| SubjectTerms | Aged Black or African American Humans Male Maryland - epidemiology Middle Aged Neighborhood Characteristics - statistics & numerical data Prostatic Neoplasms - epidemiology Prostatic Neoplasms - ethnology Prostatic Neoplasms - pathology White |
| Title | Neighborhood Disadvantage and Prostate Tumor Aggressiveness among African American and European American Men |
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