Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study

Tomic, Katarina; Ventimiglia, Eugenio; Robinson, David; Häggström, Christel; Lambe, Mats; Stattin, Pär

doi:10.1002/ijc.31272

Cited by 61 publications

(40 citation statements)

References 24 publications

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“…As yet there is little evidence regarding the potential relationship between deprivation levels and prostate cancer mortality. Some studies which used socioeconomic variables at an individual level did find evidence of positive social gradients in prostate cancer mortality [47,48]. However, our study did not provide conclusive results, possibly due to the utilization of data at census-tract rather than individual level.…”

Section: Prostate Cancercontrasting

confidence: 90%

Geographical variations in cancer mortality and social inequalities in southern Spain (Andalusia). 2002-2013

Santos-Sánchez

Córdoba-Doña

Viciana³

et al. 2020

PLoS ONE

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Introduction Geographical variations in cancer mortality can be explained, in part, by their association with social inequalities. The objective of our study was to analyse the spatial pattern of mortality in relation to the most common causes of cancer in the Spanish autonomous community of Andalusia and its possible association with social inequalities. Materials and methods A small area cross-sectional study in Andalusia, with census tracts as units of spatial analysis, for the period 2002-2013. Cases and person-years, sex and age group came from the Longitudinal Population Database of Andalusia. Standardized mortality rates and smoothed risk ratios were calculated using the Besag, York and Mollié model for lung, colorectal, breast, prostate, bladder and stomach cancer. In order to evaluate the association with social inequalities we included the deprivation index of the census tract as a covariate. Results The results show an East-West mortality pattern with higher risk in the west for lung and bladder cancer among men, and breast cancer among women. For all of Andalusia, the association between deprivation index of the census tract and mortality relative risks is positive and significant for lung, stomach and bladder cancers in men, while in women we observed a negative association for lung cancer and a positive for stomach cancer. Conclusions Knowledge regarding the spatial distribution of cancer mortality and the socioeconomic inequalities related should contribute to the design of specific health and social policies-PLOS ONE

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Section: Prostate Cancercontrasting

confidence: 90%

Geographical variations in cancer mortality and social inequalities in southern Spain (Andalusia). 2002-2013

Santos-Sánchez

Córdoba-Doña

Viciana³

et al. 2020

PLoS ONE

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“…Previous studies have shown contradictory results on the association between adult SEP and incident PCa. Positive associations ( 10 – 14 , 18 , 19 , 21 ), inverse associations ( 15 , 20 , 22 , 24 ) or no association ( 23 ) have indeed been observed. Inconsistent results have also been reported across studies that considered the period of introduction of PSA testing ( 7 , 43 – 46 ).…”

Section: Discussionmentioning

confidence: 97%

“…Socioeconomic position (SEP) ( 7 ) represents an umbrella of factors that may collectively influence the burden of PCa, including behavioral and environmental risk factors as well as access to health care (e.g., cancer screening). There is mounting evidence that a favorable SEP is associated with better PCa survival ( 8 – 10 ). However, the relationship between SEP and PCa incidence is much less clear, with studies documenting positive, negative, or no associations ( 11 – 24 ), even when the timing of introduction of the prostate specific antigen (PSA) test is taken onto account.…”

Section: Introductionmentioning

confidence: 99%

Disadvantageous Socioeconomic Position at Specific Life Periods May Contribute to Prostate Cancer Risk and Aggressiveness

et al. 2018

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Background: Previous studies on socioeconomic position (SEP) and risk of prostate cancer (PCa) have produced contradictory results. Most measured SEP only once during the individuals' life span. The aim of the study was to identify life course models that describe best the relationship between SEP measured during childhood/adolescence, early- and late-adulthood, and risk of PCa overall as well as according to tumor aggressiveness at diagnosis.Methods: We used data from a population-based case-control study of PCa conducted in the predominantly French-speaking population in Montreal, Canada. Cases (n = 1,930) with new, histologically-confirmed PCa were ascertained across hospitals deserving the French-speaking population in 2005–2009. Controls (n = 1,991), selected from Quebec's list of French-speaking electors, were frequency-matched to cases (±5 years). In-person interviews collected information on socio-demographic and lifestyle characteristics, and a complete occupational history. Measures of SEP during childhood/adolescence included parents' ownership of a car and father's longest occupation, while the subject's first and longest occupations were used to indicate early- and late-adulthood SEP, respectively. We used the Bayesian relevant life course exposure model to investigate the relationship between lifelong SEP and PCa risk.Results: Cumulative exposure to disadvantageous SEP was associated with about a 50% increase in odds of developing PCa. Late-adulthood SEP was identified as a sensitive period for aggressive PCa. Childhood/adolescence SEP based on parents' ownership of a car was associated with non-aggressive PCa. Associations were independent from PCa screening.Conclusion: Disadvantageous SEP over the life course was associated with higher PCa incidence, with consistent evidence of sensitive time periods for cancer aggressiveness. The mechanisms through which disadvantageous SEP relates to PCa risk need to be further elucidated.

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“…24 This difference may relate to our years of inclusion being more recent than prior studies and may signal a shift in the direction of disparities, as others have found in more contemporary cohorts. 25 Future research in this area is needed. Last, we found a significant, albeit smaller, increase in AS among patients with unfavorable intermediate-risk disease, despite AS not being an accepted standard of care by the NCCN.…”

Section: Discussionmentioning

confidence: 99%

Use and early mortality outcomes of active surveillance in patients with intermediate‐risk prostate cancer

Butler

Mahal

Lamba

et al. 2019

Cancer

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BACKGROUND: Certain patients with intermediate-risk prostate cancer (PCa) may be appropriate candidates for active surveillance (AS). In the current study, the authors sought to characterize AS use and early mortality outcomes for patients with intermediate-risk PCa in the United States. METHODS: The novel Surveillance, Epidemiology, and End Results Active Surveillance/Watchful Waiting database identified 52,940 men diagnosed with National Comprehensive Cancer Network intermediate-risk PCa (cT2b-c, Gleason score of 7, or a prostate-specific antigen level of 10-20 ng/mL) and actively managed (AS, radiotherapy, or radical prostatectomy) from 2010 through 2015. The Cuzick test assessed AS time trends, and logistic multivariable regression characterized features associated with AS. Fine-Gray and Cox modeling determined PCa-specific mortality (PCSM) and overall survival, respectively. RESULTS: The rate of AS increased from 3.7% in 2010 to 7.3% in 2015, and from 7.2% to 11.7% among men aged ≥70 years. Among men with favorable and unfavorable intermediate-risk disease, the use of AS increased from 7.2% to 14.9% and from 2.2% to 3.8%, respectively (all P value for trend, <.001). The mean age of those patients managed with AS decreased from 69.9 years to 67.9 years (P = .0004). Factors found to be associated with AS included favorable risk disease; black race; higher socioeconomic status; older age; and diagnosis in the West, Northwest, or Midwest regions of the United States. The 5-year PCSM rate was comparable to AS versus treatment among patients with low-risk and favorable intermediate-risk disease, but was worse with AS among those with unfavorable intermediate-risk disease (PCSM, 1.3% vs 0.5%; adjusted hazard ratio, 2.48 [95% CI, 1.11-5.50; P = .026]) and intermediate-risk disease overall (PCSM, 1.1% vs 0.4%; adjusted hazard ratio, 2.34 [95% CI, 1.25-4.37; P = .008]). CONCLUSIONS: The use of AS for patients with intermediate-risk PCa is increasing across the United States, particularly for older men and those with favorable intermediate-risk disease. Early estimates of cancer-specific and overall mortality rates are low with AS, although significantly higher compared with treatment. Cancer 2019;125:3164-3171.

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Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study

Cited by 61 publications

References 24 publications

Geographical variations in cancer mortality and social inequalities in southern Spain (Andalusia). 2002-2013

Geographical variations in cancer mortality and social inequalities in southern Spain (Andalusia). 2002-2013

Disadvantageous Socioeconomic Position at Specific Life Periods May Contribute to Prostate Cancer Risk and Aggressiveness

Use and early mortality outcomes of active surveillance in patients with intermediate‐risk prostate cancer

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