A Systematic Review and Meta-Analysis of Patient Race, Ethnicity, Socioeconomic Status and Educational Attainment in Prostate Cancer Treatment Randomised Trials – Is the Evidence Base Applicable to the General Patient Population?

Patki, Siddhant; Aquilina, Julian; Thorne, Rebecca Jayne; Aristidou, Isaac; Rodrigues, Filipe; Warren, Hannah; Bex, Axel; Kasivisvanathan, Veeru; Moore, Caroline; Gurusamy, Kurinchi; Emberton, Mark; Best, Lawrence; Tran, Maxine

doi:10.2139/ssrn.4290629

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“…Of note, AA with lower rates of education were diagnosed with prostate cancer at higher rates compared to those with higher education, perhaps due to effects of past discrimination and injustice that correlate with low educational attainment and disease risk. These findings align with a systematic review that found that prostate cancer primarily affects AA men, and those reporting lower socioeconomic status and educational attainment 38 . However, in our cohort this pattern was not observed among EA.…”

Section: Discussionsupporting

confidence: 92%

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Association of neighborhood gentrification with prostate cancer and immune markers in African American and European American men

Pichardo,

Ezeani,

Pichardo

et al. 2023

Cancer Medicine

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BackgroundPrior studies showed that neighborhood deprivation increases the risk of lethal prostate cancer. However, the role of neighborhood gentrification in prostate cancer development and outcome remains poorly understood. We examined the relationships of gentrification with prostate cancer and serum proteome‐defined inflammation and immune function in a diverse cohort.MethodsThe case–control study included 769 cases [405 African American (AA), 364 European American (EA) men] and 1023 controls (479 AA and 544 EA), with 219 all‐cause and 59 prostate cancer‐specific deaths among cases. Geocodes were linked to a neighborhood gentrification index (NGI) derived from US Census data. Cox and logistic regression, and MANOVA, were used to determine associations between NGI, as continuous or quintiles (Q), and outcomes.ResultsAdjusting for individual socioeconomic status (SES), continuous NGI was positively associated with prostate cancer among all men (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01–1.14). AA and low‐income men experienced the highest odds of prostate cancer when residing in tracts with moderate gentrification, whereas EA men experienced reduced odds of regional/metastatic cancer with increased gentrification in SES‐adjusted analyses. Continuous NGI also associated with mortality among men presenting with localized disease and low‐income men in SES‐adjusted Cox regression analyses. NGI was not associated with serum proteome‐defined chemotaxis, inflammation, and tumor immunity suppression.ConclusionsFindings show that neighborhood gentrification associates with prostate cancer and mortality in this diverse population albeit associations were heterogenous within subgroups. The observations suggest that changing neighborhood socioeconomic environments may affect prostate cancer risk and outcome, likely through multifactorial mechanisms.

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Section: Discussionsupporting

confidence: 92%

“…These findings align with a systematic review that found that prostate cancer primarily affects AA men, and those reporting lower socioeconomic status and educational attainment. 38 However, in our cohort this pattern was not observed among EA. One-third of EA cases reported high levels of income, which translates to greater access to screenings.…”

Section: Notecontrasting

confidence: 74%