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 N. Kryvenko, Deliang Tang, Benjamin A. Rybicki

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

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

Keywords

  • Incidence
  • Prostate cancer
  • Screening
  • Socioeconomic status

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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