MP04-07 POVERTY IS ASSOCIATED WITH ADVERSE PROSTATE CANCER PATHOLOGY AMONG AFRICAN-AMERICAN MEN UNDERGOING RADICAL PROSTATECTOMY

Abstract

INTRODUCTION AND OBJECTIVES: Prior studies have suggested that poverty is associated with advanced stage or aggressive prostate cancer at presentation. However, due to strong associations between poverty and race, the independent contribution of poverty, irrespective of race, remains unclear. To eliminate potential confounding, we sought to test for an association between poverty and adverse pathology in a population comprised exclusively of African-American (AA) men treated with radical prostatectomy (RP). METHODS: African American men who underwent radical prostatectomy between September 2010 and September 2015 at Temple University Hospital and the University of Pennsylvania were identified through our institutional databases. Median household income for each patient’s residential zip code was determined using United States Census Bureau data. The median income for the study population was calculated, and patients were stratified as either lowor high-income relative to the median. Pathological outcomes, CAPRA-S score, and rates of adverse pathology (defined as pathological stage pT3, pathological Gleason score 4+3, or lymph node involvement) were compared between income groups. Linear and logistic regression were used to test for associations of income with CAPRA-S score and adverse pathology, respectively. RESULTS: 385 African American men met inclusion criteria. Median household income was $40,031 (range $14,297-$162,617), The table compares disease-specific and pathological outcomes between low and high income men. Low income men had significantly higher PSA values (p<0.01), rates of seminal vesicle invasion (p<0.01), positive margin rates (p<0.01), CAPRA-S scores (p<0.01), and rates of adverse pathology (p1⁄40.02). Linear and logistic regression showed significant inverse associations of patient income with CAPRA-S score (p<0.01) and adverse pathology (p1⁄40.03). CONCLUSIONS: We observed a significant association of poverty with adverse pathology in a population of African-American men treated with RP. This suggests that poverty, irrespective of race, is associated with advanced stage or aggressive prostate cancers. Community outreach, education, and screening efforts should target low-income men to decrease prostate cancer morbidity. Source of Funding: None