Abstract 4351: A neighborhood-wide association study (NWAS) in prostate cancer: A new methodologic approach

Abstract

Abstract Background: Cancer results from complex interactions of multiple variables at biological, individual and social levels. However, comprehensive, empirical methods to assess social and neighborhood-level effects are limited. We propose a Neighborhood-Wide Association Study(NWAS), analogous to a genome-wide association study(GWAS), to comprehensively identify neighborhood signatures associated with disease. Methods: Pennsylvania State Cancer Registry data from 1995-2005 were linked to the 2000 U.S. Census data. In a successively more stringent multiphase approach, we evaluated the association between neighborhood exposures(n = 14,663, standard deviation adjusted census variables) and prostate cancer aggressiveness (n = 6,416 aggressive Stage>3/Gleason grade >7 cases vs. n = 70,670 non-aggressive Stage<3/Gleason grade<7 controls) in White men. Each phase accounted for age, year of diagnosis, spatial correlation, and multiple testing. We used generalized estimating equations in Phase 1 and Bayesian mixed effects models in Phase 2 to calculate odds ratios(OR) and credible intervals(CI). Variables meeting statistically significant thresholds after Bonferroni adjustment were identified and used in subsequent phases. In Phase 3, principal components analysis grouped correlated variables. Results: From 14,663 census variables, 17 variables that were most significantly associated with prostate cancer aggressiveness were identified. The top two hits related to transportation (OR = 1.05;CI = 1.001-1.09) and poverty (OR = 1.07;CI = 1.01-1.12). Significant associations between prostate cancer and income, housing, employment, and immigration were also found. Conclusions: This NWAS methodology addresses gaps in neighborhood and cancer research by proposing a standardized, agnostic evaluation of neighborhood using readily accessible data from the U.S. Census. This approach has implications for health disparities research and can be applied broadly to large-scale, public health data. Citation Format: Shannon Lynch, Nandita Mitra, Michelle Ross, Craig Newcomb, Karl Daily, Tara Jackson, Charnita Zeigler-Johnson, Harold Riethman, Charles Branas, Timothy Rebbeck. A neighborhood-wide association study (NWAS) in prostate cancer: A new methodologic approach. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4351.