Abstract
Black men are more likely than Non-Hispanic White (NHW) men to be diagnosed with high-risk prostate cancer. We examined the extent to which social factors were associated with differences in prostate cancer risk profiles between Black men and NHW men [using a modification to the original D'Amico risk groups based on prostate specific antigen (PSA), Gleason score (GS), and TNM stage (stage)], based on individual and combined clinicopathologic characteristics. We conducted a cross-sectional population-based study of 23,555 Black men and 146,889 NHW men diagnosed with prostate cancer in the California Cancer Registry from 2004 to 2017. We conducted multivariable logistic regression to examine the association of year of diagnosis, block group-level neighborhood socioeconomic status (nSES), marital status, and insurance type on differences in prostate cancer risk profiles between Black and NHW men. High PSA (>20 ng/mL), GS, stage, individually and combined prostate cancer risk profiles were more common among Black men versus NHW men. In fully adjusted models, relative to NHW men, we observed a persistent 67% increased odds of high PSA among Black men. nSES was the factor most strongly associated with racial disparity in high PSA, accounting for 25% of the difference. Marital status was the factor that was second most associated with a racial disparity. nSES was the factor most strongly associated with racial disparities in high PSA prostate cancer. The influence of nSES on racial disparities in PSA, GS, stage, and prostate cancer risk profiles warrants further consideration.
Highlights
Prostate cancer (PCa) is the most common cancer among men in the United States
We conducted a cross-sectional population-based study of 23,555 Black men and 146,889 Non-Hispanic White (NHW) men diagnosed with prostate cancer (PCa) in the California Cancer Registry from 2004 to 2017
In comparison to NWH men, Black men were more likely to reside in lowest SES neighborhoods (24.2% compared to 6.6%), more likely to be unmarried (41.7% compared to 24.2%), less likely to have Medicare insurance (13.2% compared to 23.7%), and more likely to have public insurance (28.9% compared to 19.1%)
Summary
Prostate cancer (PCa) is the most common cancer among men in the United States. In 2021, Black men are projected to experience 1.8 times the incidence and 2.1 times the mortality as non-Hispanic White (NHW) men [1]. Black men are more likely than Non-Hispanic White (NHW) men to be diagnosed with high-risk prostate cancer (PCa). We examined the extent to which social factors were associated with differences in PCa risk profiles between Black men and NHW men (using a modification to the original D’Amico risk groups based on prostate specific antigen (PSA), Gleason score (GS), and TNM stage (stage)), based on individual and combined clinicopathologic characteristics. We conducted multivariable logistic regression to examine the association of year of diagnosis, block group-level neighborhood socioeconomic status (nSES), marital status, and insurance type on differences in PCa risk profiles between Black and NHW men. Results: High PSA (>20 ng/mL), GS, stage, individually and combined PCa risk profiles were more common among Black men versus NHW men. Impact: The influence of nSES on racial disparities in PSA, GS, stage, and PCa risk profiles warrants further consideration
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call