Neighborhood deprivation and risk of mortality among men with prostate cancer: Findings from a long-term follow-up study.
Neighborhood deprivation and risk of mortality among men with prostate cancer: Findings from a long-term follow-up study.
复制标题
DOI：
10.1002/pros.24320
复制
发表时间：
2022-05
期刊：
影响因子：
2.8
通讯作者：
Peters, Edward S.
中科院分区：
文献类型：
--
作者：
Madhav, K. C.;Oral, Evrim;Rung, Ariane L.;Trapido, Edward J.;Rozek, Laura S.;Fontham, Elizabeth T. H.;Bensen, Jeannette T.;Farnan, Laura;Steck, Susan E.;Song, Lixin;Mohler, James L.;Peters, Edward S.
前列腺癌（PCa）的总体生存率在过去几十年中有所提高。然而，在总体和前列腺癌特异性死亡率方面存在巨大的社会经济和种族差异。社区层面的因素，包括社会经济劣势和缺乏获得护理的机会，可能会导致癌症死亡率的差异。本研究探讨了社区剥夺对PCa幸存者死亡率的影响。使用北卡罗来纳州-路易斯安那州前列腺癌项目（PCaP）数据。共有2113名男性，1046名AA和1067名EA，患有PCa。邻里贫困是衡量的地区贫困指数（ADI）在人口普查块组水平使用的数据来自美国人口普查局。创建了ADI昆泰。采用混合效应的考克斯比例风险和竞争风险模型，估计社区剥夺对全因死亡率和PCa特异性死亡率的影响，并根据年龄、种族、研究中心、保险状态和合并症进行了校正。生活在最贫困社区的参与者与生活在最贫困社区（五分位数1）的参与者相比，全因死亡的风险增加（五分位数4 + 5：调整后的风险比[aHR] = 1.51，95%置信区间[CI] = 1.16-1.96）。生活在贫困社区的人群中前列腺癌特异性死亡率的风险也高于生活在最贫困社区的人群（五分位数4 + 5：aHR = 1.90，95% CI = 1.10-3.50）。研究结果表明，社区一级的资源或健康干预措施对改善PCa男性的生存率至关重要。更多的研究应该集中在邻里环境如何影响死亡率的机制上。
The overall survival rate of prostate cancer (PCa) has improved over the past decades. However, huge socioeconomic and racial disparities in overall and prostate cancer‐specific mortality exist. The neighborhood‐level factors including socioeconomic disadvantage and lack of access to care may contribute to disparities in cancer mortality. This study examines the impact of neighborhood deprivation on mortality among PCa survivors. North Carolina–Louisiana Prostate Cancer Project (PCaP) data were used. A total of 2113 men, 1046 AA and 1067 EA, with PCa were included in the analysis. Neighborhood deprivation was measured by the Area Deprivation Index (ADI) at the census block group level using data from the US Census Bureau. Quintiles of ADI were created. Cox proportional hazards and competing risk models with mixed effects were performed to estimate the effect of neighborhood deprivation on all‐cause and PCa‐specific mortality adjusted for age, race, study site, insurance status, and comorbidities. Participants living in the most deprived neighborhoods had an increased risk for all‐cause mortality (quintiles 4 + 5: adjusted hazard ratio [aHR] = 1.51, 95% confidence interval [CI] = 1.16–1.96) compared to those in the least deprived (quintile 1) neighborhoods. The risk of prostate cancer‐specific mortality was also higher among those living in the deprived neighborhoods (quintiles 4 + 5: aHR = 1.90, 95% CI = 1.10–3.50) than those in the least deprived neighborhood. The findings suggest neighborhood‐level resources or health interventions are essential to improve survival among men with PCa. Additional research should focus on the mechanisms of how the neighborhood environment affects mortality.
登录
查看更多内容
影响因子：
2.3
作者：
Batty, G. David;Kivimaeki, Mika;Clarke, Robert;Smith, George Davey;Shipley, Martin J.
通讯作者：
Shipley, Martin J.
影响因子：
23.4
作者：
Islami F;Moreira DM;Boffetta P;Freedland SJ
通讯作者：
Freedland SJ
影响因子：
3.2
作者：
Anderson, Kathryn Freeman
通讯作者：
Anderson, Kathryn Freeman
影响因子：
4
作者：
Hamano, Tsuyoshi;Li, Xinjun;Sundquist, Kristina
通讯作者：
Sundquist, Kristina
影响因子：
1.5
作者：
Jan, Michael;Bonn, Stephanie E.;Balter, Katarina
通讯作者：
Balter, Katarina