A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer

Andrew Rundle, Kathryn M. Neckerman, Daniel Sheehan, Michelle Jankowski, Oleksandr Kryvenko, Deliang Tang, Benjamin A. Rybicki

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Purpose: Higher socioeconomic status (SES) men are at higher risk of prostate cancer (PCa) diagnosis, an association commonly interpreted as a function of higher rates of prostate screening among higher SES men. However, the extent to which screening explains this association has not been well quantified. Methods: Within a Detroit area cohort of 6,692 men followed up after a benign prostate procedure, a case-control study was conducted of 494 PCa cases and controls matched on age, race, duration of follow-up, and date of initial benign finding; 2000 Census data were used in a principal component analysis to derive a single factor, labeled the neighborhood SES index (NSESI), representing zip code-level SES. Results: Among cases, higher SES was associated with a younger age at initial biopsy: -1.48 years (95 % CI, -2.32, -0.64) per unit NSESI. After adjustment for confounders and duration of follow-up, higher SES was associated with more PSA tests and DRE during follow-up; 9 % (95 % CI, 2, 16) and 8 % (95 % CI, 1, 15) more respectively, per unit NSESI. Higher SES was associated with a higher risk of PCa diagnosis during follow-up, multivariable adjusted OR = 1.26 per unit increase in NSESI (95 % CI, 1.04, 1.49). Further adjustment for screening frequency somewhat reduced the association between SES and PCa risk (OR = 1.19 per unit NSESI, 95 % CI, 0.98, 1.44). Conclusions: Differences in screening frequency only partially explained the association between higher zip code SES and PCa risk; other health care-related factors should also be considered as explanatory factors.

Original languageEnglish (US)
Pages (from-to)297-303
Number of pages7
JournalCancer Causes and Control
Volume24
Issue number2
DOIs
StatePublished - Feb 2013
Externally publishedYes

Fingerprint

Early Detection of Cancer
Social Class
Prostatic Neoplasms
Prospective Studies
Incidence
Prostate
Censuses
Principal Component Analysis
Case-Control Studies
Delivery of Health Care
Biopsy

Keywords

  • Incidence
  • Prostate cancer
  • Screening
  • Socioeconomic status

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer. / Rundle, Andrew; Neckerman, Kathryn M.; Sheehan, Daniel; Jankowski, Michelle; Kryvenko, Oleksandr; Tang, Deliang; Rybicki, Benjamin A.

In: Cancer Causes and Control, Vol. 24, No. 2, 02.2013, p. 297-303.

Research output: Contribution to journalArticle

Rundle, Andrew ; Neckerman, Kathryn M. ; Sheehan, Daniel ; Jankowski, Michelle ; Kryvenko, Oleksandr ; Tang, Deliang ; Rybicki, Benjamin A. / A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer. In: Cancer Causes and Control. 2013 ; Vol. 24, No. 2. pp. 297-303.
@article{8e7cb8b23e674849ad973082e925e453,
title = "A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer",
abstract = "Purpose: Higher socioeconomic status (SES) men are at higher risk of prostate cancer (PCa) diagnosis, an association commonly interpreted as a function of higher rates of prostate screening among higher SES men. However, the extent to which screening explains this association has not been well quantified. Methods: Within a Detroit area cohort of 6,692 men followed up after a benign prostate procedure, a case-control study was conducted of 494 PCa cases and controls matched on age, race, duration of follow-up, and date of initial benign finding; 2000 Census data were used in a principal component analysis to derive a single factor, labeled the neighborhood SES index (NSESI), representing zip code-level SES. Results: Among cases, higher SES was associated with a younger age at initial biopsy: -1.48 years (95 {\%} CI, -2.32, -0.64) per unit NSESI. After adjustment for confounders and duration of follow-up, higher SES was associated with more PSA tests and DRE during follow-up; 9 {\%} (95 {\%} CI, 2, 16) and 8 {\%} (95 {\%} CI, 1, 15) more respectively, per unit NSESI. Higher SES was associated with a higher risk of PCa diagnosis during follow-up, multivariable adjusted OR = 1.26 per unit increase in NSESI (95 {\%} CI, 1.04, 1.49). Further adjustment for screening frequency somewhat reduced the association between SES and PCa risk (OR = 1.19 per unit NSESI, 95 {\%} CI, 0.98, 1.44). Conclusions: Differences in screening frequency only partially explained the association between higher zip code SES and PCa risk; other health care-related factors should also be considered as explanatory factors.",
keywords = "Incidence, Prostate cancer, Screening, Socioeconomic status",
author = "Andrew Rundle and Neckerman, {Kathryn M.} and Daniel Sheehan and Michelle Jankowski and Oleksandr Kryvenko and Deliang Tang and Rybicki, {Benjamin A.}",
year = "2013",
month = "2",
doi = "10.1007/s10552-012-0108-6",
language = "English (US)",
volume = "24",
pages = "297--303",
journal = "Cancer Causes and Control",
issn = "0957-5243",
publisher = "Springer Netherlands",
number = "2",

}

TY - JOUR

T1 - A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer

AU - Rundle, Andrew

AU - Neckerman, Kathryn M.

AU - Sheehan, Daniel

AU - Jankowski, Michelle

AU - Kryvenko, Oleksandr

AU - Tang, Deliang

AU - Rybicki, Benjamin A.

PY - 2013/2

Y1 - 2013/2

N2 - Purpose: Higher socioeconomic status (SES) men are at higher risk of prostate cancer (PCa) diagnosis, an association commonly interpreted as a function of higher rates of prostate screening among higher SES men. However, the extent to which screening explains this association has not been well quantified. Methods: Within a Detroit area cohort of 6,692 men followed up after a benign prostate procedure, a case-control study was conducted of 494 PCa cases and controls matched on age, race, duration of follow-up, and date of initial benign finding; 2000 Census data were used in a principal component analysis to derive a single factor, labeled the neighborhood SES index (NSESI), representing zip code-level SES. Results: Among cases, higher SES was associated with a younger age at initial biopsy: -1.48 years (95 % CI, -2.32, -0.64) per unit NSESI. After adjustment for confounders and duration of follow-up, higher SES was associated with more PSA tests and DRE during follow-up; 9 % (95 % CI, 2, 16) and 8 % (95 % CI, 1, 15) more respectively, per unit NSESI. Higher SES was associated with a higher risk of PCa diagnosis during follow-up, multivariable adjusted OR = 1.26 per unit increase in NSESI (95 % CI, 1.04, 1.49). Further adjustment for screening frequency somewhat reduced the association between SES and PCa risk (OR = 1.19 per unit NSESI, 95 % CI, 0.98, 1.44). Conclusions: Differences in screening frequency only partially explained the association between higher zip code SES and PCa risk; other health care-related factors should also be considered as explanatory factors.

AB - Purpose: Higher socioeconomic status (SES) men are at higher risk of prostate cancer (PCa) diagnosis, an association commonly interpreted as a function of higher rates of prostate screening among higher SES men. However, the extent to which screening explains this association has not been well quantified. Methods: Within a Detroit area cohort of 6,692 men followed up after a benign prostate procedure, a case-control study was conducted of 494 PCa cases and controls matched on age, race, duration of follow-up, and date of initial benign finding; 2000 Census data were used in a principal component analysis to derive a single factor, labeled the neighborhood SES index (NSESI), representing zip code-level SES. Results: Among cases, higher SES was associated with a younger age at initial biopsy: -1.48 years (95 % CI, -2.32, -0.64) per unit NSESI. After adjustment for confounders and duration of follow-up, higher SES was associated with more PSA tests and DRE during follow-up; 9 % (95 % CI, 2, 16) and 8 % (95 % CI, 1, 15) more respectively, per unit NSESI. Higher SES was associated with a higher risk of PCa diagnosis during follow-up, multivariable adjusted OR = 1.26 per unit increase in NSESI (95 % CI, 1.04, 1.49). Further adjustment for screening frequency somewhat reduced the association between SES and PCa risk (OR = 1.19 per unit NSESI, 95 % CI, 0.98, 1.44). Conclusions: Differences in screening frequency only partially explained the association between higher zip code SES and PCa risk; other health care-related factors should also be considered as explanatory factors.

KW - Incidence

KW - Prostate cancer

KW - Screening

KW - Socioeconomic status

UR - http://www.scopus.com/inward/record.url?scp=84878857403&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878857403&partnerID=8YFLogxK

U2 - 10.1007/s10552-012-0108-6

DO - 10.1007/s10552-012-0108-6

M3 - Article

C2 - 23224323

AN - SCOPUS:84878857403

VL - 24

SP - 297

EP - 303

JO - Cancer Causes and Control

JF - Cancer Causes and Control

SN - 0957-5243

IS - 2

ER -