Abstract A71: Modification of obesity associations with prostate cancer grade by area-level factors

Abstract

Abstract Purpose: Area-level characteristics have been associated with differences in rates of disease among populations. Specific factors, such as neighborhood socioeconomic status (SES), may influence overall exposure to risk factors and modify disease outcomes. The role of obesity in prostate cancer (PCa) progression has been confirmed with most studies showing a relationship to advanced disease and increased risk for biochemical failure and mortality. Although obesity and prostate cancer rates vary geographically, it is unclear if the relationship between obesity and PCa outcomes is modified by neighborhood factors. We evaluated the association of obesity with prostate cancer grade by area-level factors in a patient cohort recruited between 1995 and 2011. Materials and Methods: A total of 949 patients were studied to evaluate whether the association of obesity with prostate tumor grade at diagnosis varied by residential neighborhood and county characteristics. Residential characteristics were obtained using PolicyMap data sources including the US Census, CDC data, and a regional survey collected biannually (CHDB). There were 680 non-obese and 269 obese patients. High tumor grade was defined as a Gleason Score ≥7. We analyzed the relationship between obesity and PCa grade using logistic regression models, adjusted for age and race. Similar models stratified by residential characteristics were assessed. Results: Obese patients were more likely to have a high PCa grade compared to the non-obese patients (OR=1.47, 95% CI= 1.10-1.96). Associations between obesity and PCa grade were also observed for individuals residing in areas with higher rates of poverty (OR=1.57, 95% CI= 1.02-2.42), lower income (OR=1.56, 95% CI= 1.01-2.41), and lower education (OR=1.68, 95% CI= 1.12-2.52). The odds ratio was increased in areas with high rates of burglary (OR=1.55, 95% CI= 1.04-2.30) and murder (OR=1.51, 95% CI= 1.01-2.25) and low rates of robbery (OR=1.63, 95% CI= 1.03-2.58). In addition, obese men in areas with low rates of prostate cancer incidence (OR=1.84, 95% CI= 1.20-2.82) and low rates of obesity (OR=1.64, 95% CI= 1.02-2.63) also were likely to have a high grade PCa. Conclusions: Associations between obesity and prostate cancer vary significantly by area-level SES, crime, and health indicators. These results suggest specific neighborhood characteristics that may help identify high risk groups and pathways for interventions. Citation Format: Renyta Scales, Elaine Spangler, Knashawn Morales, Karen Glanz, Timothy Rebbeck, Charnita Zeigler-Johnson. Modification of obesity associations with prostate cancer grade by area-level factors. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A71.