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    Socioeconomic status, healthcare density, and risk of prostate cancer among African American and Caucasian men in a large prospective study

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    Authors
    Major, Jacqueline M.
    Oliver, M. Norman
    Doubeni, Chyke A.
    Hollenbeck, Albert R.
    Graubard, Barry I.
    Sinha, Rashmi
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Family Medicine and Community Health
    Document Type
    Journal Article
    Publication Date
    2012-07-01
    Keywords
    Prostatic Neoplasms
    Prospective Studies
    Community Health and Preventive Medicine
    Epidemiology
    Male Urogenital Diseases
    Neoplasms
    Preventive Medicine
    Primary Care
    
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    Link to Full Text
    http://dx.doi.org/10.1007/s10552-012-9988-8
    Abstract
    OBJECTIVES: The purpose of this study was to separately examine the impact of neighborhood socioeconomic deprivation and availability of healthcare resources on prostate cancer risk among African American and Caucasian men. METHODS: In the large, prospective NIH-AARP Diet and Health Study, we analyzed baseline (1995-1996) data from adult men, aged 50-71 years. Incident prostate cancer cases (n = 22,523; 1,089 among African Americans) were identified through December 2006. Lifestyle and health risk information was ascertained by questionnaires administered at baseline. Area-level socioeconomic indicators were ascertained by linkage to the US Census and the Area Resource File. Multilevel Cox models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). RESULTS: A differential effect among African Americans and Caucasians was observed for neighborhood deprivation (p-interaction = 0.04), percent uninsured (p-interaction = 0.02), and urologist density (p-interaction = 0.01). Compared to men living in counties with the highest density of urologists, those with fewer had a substantially increased risk of developing advanced prostate cancer (HR = 2.68, 95 % CI = 1.31, 5.47) among African American. CONCLUSIONS: Certain socioeconomic indicators were associated with an increased risk of prostate cancer among African American men compared to Caucasians. Minimizing differences in healthcare availability may be a potentially important pathway to minimizing disparities in prostate cancer risk.
    Source

    Cancer Causes Control. 2012 Jul;23(7):1185-91. Epub 2012 May 22. Link to article on publisher's site

    DOI
    10.1007/s10552-012-9988-8
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/30906
    PubMed ID
    22674292
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1007/s10552-012-9988-8
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