Racial Disparity and Socioeconomic Status in Association With Survival in Older Men with Local/Regional Stage Prostate Cancer: Findings From a Large Community-Based Cohort

Authors

Xianglin L. Du, University of Texas Health Science Center at HoustonFollow
Shenying Fang, University of Texas Health Science Center at Houston
Ann L. Coker, University of Texas Health Science Center at HoustonFollow
Corinne Aragaki, University of Texas Health Science Center at Houston
Janice N. Cormier, University of Texas M.D. Anderson Cancer CenterFollow
Yan Xing, University of Texas M.D. Anderson Cancer Center
Beverly J. Gor, University of Texas M.D. Anderson Cancer Center
Wenyaw Chan, University of Texas Health Science Center at HoustonFollow

Abstract

BACKGROUND

Few studies have examined the outcomes for Hispanic men with prostate carcinoma and incorporated socioeconomic factors in association with race/ethnicity in affecting survival, adjusting for factors on cancer stage, grade, comorbidity, and treatment.

METHODS

We studied a population-based cohort of 61,228 men diagnosed with local or regional stage prostate carcinoma at age 65 years or older between 1992 and 1999 in the 11 SEER (Surveillance, Epidemiology, and End Results) areas, identified from the SEER-Medicare linked data with up to 11 years of followup.

RESULTS

Low socioeconomic status was significantly associated with decreasing survival in all men with prostate carcinoma. Those living in the community with the lowest quartile of socioeconomic status were 31% more likely to die than those living in the highest quartile (hazard ratio [HR] of all-cause mortality: 1.31; 95% confidence interval [CI]: 1.25–1.36) after adjustment for patient age, comorbidity, Gleason score, and treatment. The HR remained almost unchanged after controlling for race/ethnicity (HR: 1.32; 95% CI: 1.26–1.38). Compared with Caucasians, the risk of mortality in African American men was marginally significantly higher (HR: 1.06; 95% CI: 1.01–1.11) after controlling for education, and no longer significant after adjusting for poverty, income, or composite socioeconomic variable; the HR was lower for Hispanic men (HR: 0.80; 95% CI: 0.72–0.89) after adjustment for education and other socioeconomic variables.

CONCLUSION

Racial disparity in survival among men with local or regional prostate carcinoma was largely explained by socioeconomic status and other factors. Lower socioeconomic status appeared to be one of the major barriers to achieving comparable outcomes for men with prostate carcinoma.

Document Type

Article

Publication Date

3-15-2006

Notes/Citation Information

Published in Cancer, v. 106, no. 6, p. 1276-1285.

Dr. Ann Coker had not been a faculty member of the University of Kentucky at the time of publication.

Digital Object Identifier (DOI)

http://dx.doi.org/10.1002/cncr.21732

Repository Citation

Du, Xianglin L.; Fang, Shenying; Coker, Ann L.; Aragaki, Corinne; Cormier, Janice N.; Xing, Yan; Gor, Beverly J.; and Chan, Wenyaw, "Racial Disparity and Socioeconomic Status in Association With Survival in Older Men with Local/Regional Stage Prostate Cancer: Findings From a Large Community-Based Cohort" (2006). CRVAW Faculty Journal Articles. 103.
https://uknowledge.uky.edu/crvaw_facpub/103