Neighborhood Disadvantage and Prostate Tumor Aggressiveness among African American and European American Men

IF 3.7 3区医学 Q2 ONCOLOGY

Cancer Epidemiology Biomarkers & Prevention Pub Date : 2024-09-12 DOI:10.1158/1055-9965.epi-24-0450

Joseph Boyle, Jessica Yau, Jimmie L. Slade, Derrick A. Butts, Jessica Wimbush, Jong Y. Park, Arif Hussain, Eberechukwu Onukwugha, Cheryl L. Knott, David C. Wheeler, Kathryn Hughes Barry

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引用次数: 0

Abstract

Background: 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. Methods: 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). Results: 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. Conclusions: We identified novel significant positive associations for racial segregation and historical redlining with aggressive prostate cancer and significant interactions between ND indices and race. Impact: 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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非裔美国人和欧裔美国人男性的邻里劣势与前列腺肿瘤侵袭性

背景：研究发现，邻里劣势（ND）与侵袭性前列腺癌之间存在关联，而邻里劣势更有可能影响非裔美国人（AA）。因此，ND 可能会导致前列腺癌的差异。然而，ND 的哪些因素会导致侵袭性疾病，以及不同种族之间的关联是否存在差异，目前还不得而知。研究方法我们评估了在马里兰大学格林鲍姆综合癌症中心接受治疗的前列腺癌男性患者（2004-2021 年）中，侵袭性前列腺癌与四个 ND 指标--地区贫困指数 (ADI)、贝叶斯验证邻里贫困指数 (NDI)、种族隔离 (RI) 指数和历史红线之间的关联，以及这些因素是否与种族相互影响。研究结果我们纳入了 1,458 名男性（698 名欧洲裔美国人和 760 名 AA）。AA 族男性更有可能出现 ND。在调整后的模型中，ADI、RI 和 Redlining 与侵袭性前列腺癌和非侵袭性前列腺癌有显著相关性 [ADI，增加一个 SD 的 OR = 1.14，95% 置信区间 (CI)，1.00-1.30；RI，OR = 1.27，CI，1.07-1.51；redlining，OR = 1.77；CI，1.23-2.56]，在 AA 族男性中也是如此。在 AA 族男性中，NDI 与侵袭性前列腺癌相关（OR = 1.32，95% 可信区间：1.13-1.57）；贫困百分比的重要性权重最大。ADI（P异质性=0.002）和NDI（超出概率异质性=98.1%）与种族有显著的交互作用，因此AA男性的相关性明显更强。结论：我们发现种族隔离和历史红线与侵袭性前列腺癌之间存在新的显著正相关，而且 ND 指数与种族之间存在显著的交互作用。影响：研究结果揭示了与侵袭性前列腺癌相关的特定 ND 成分，并表明 AA 族男性的 ND 效应更强，这对减少差异的干预措施具有重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

2.60%

发文量

538

审稿时长

1.6 months

期刊介绍： Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.