Multilevel Analysis of Neighborhood Characteristics and Prostate Cancer

Abstract

The goal of this study was to examine neighborhood characteristics in relation to prostate cancer severity. Methods: We studied African-American and Caucasian prostate cancer cases from the Pennsylvania State Cancer Registry. Census tract-level variables and deprivation scores were examined in relation to diagnosis age, stage, grade, and tumor aggressiveness. Multilevel analyses were conducted on a subset of patients from a longitudinal hospital-based study to examine the effects of neighborhood variables taking account of patient-level variables. Results: We observed associations of socioeconomic status (SES) with high Gleason score among African-Americans residing in neighborhoods with low educational attainment (OR=1.34, 95% CI=1.13-1.60), high poverty (OR=1.39, 95% CI=1.15- 1.67), low car ownership (OR=1.46, 95% CI=1.20-1.78), and higher percentage of residents on public assistance (OR=1.32, 95%=1.08- 1.62). The highest quartile of neighborhood deprivation was also associated with high Gleason score. For both Caucasians and African-Americans, the highest quartile of neighborhood deprivation was associated with high Gleason score at diagnosis (OR=1.34, 95% CI=1.19-1.52; OR=1.71, 95% CI=1.21- 2.40, respectively.) Older age (65+ years) at diagnosis was also associated with low SES in African-Americans in Caucasians. In multilevel analyses, patient-level risk factors were significantly associated with most outcomes under investigation. However, in the African-American sample, we did observe associations of advanced tumor grade with neighborhood crime and advanced tumor stage with percentage of female-headed households and residents on public assistance in the neighborhood. neighborhood SES, sociodemographics and crime that may affect advanc

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Document Details

Document Type
Technical Report
Publication Date
Sep 01, 2012
Accession Number
ADA574693

Entities

People

  • Charnita M Zeigler-Johnson

Organizations

  • University of Pennsylvania

Tags

DTIC Thesaurus Topics

  • African Americans
  • Caucasians
  • Census
  • Demography
  • Disease Attributes
  • Diseases And Disorders
  • Ethnic Groups
  • Families (Human)
  • Geographic Regions
  • Health
  • Health Services
  • Medical Personnel
  • Minority Groups
  • Neoplasms
  • Prostate Cancer
  • Public Health
  • Risk Factors

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