Socioeconomic Status And The Aggressiveness Of Prostate Cancer Among Black Males
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Type of WorkText
DepartmentPublic Health and Policy
ProgramDoctor of Public Health
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Prostate cancer, the leading non-skin malignant cancer among men, affects black men disproportionately. Black men are typically diagnosed at an earlier age and have a higher rate of aggressive tumors compared to other races. This study investigates the relationship of socioeconomic status on prostate cancer severity and mortality among black men. The purpose of the study is to determine whether prostate cancer risk, the aggressiveness of disease, and mortality differ by socioeconomic status. Two datasets were utilized. A total of 715 black men with a prostate cancer diagnosis were studied using individual-level data from the linked Surveillance, Epidemiology, and End Results National, Longitudinal and Mortality Study (SEER NLMS) database. Socioeconomic status was assessed and stage and grade of prostate cancer from the medical histories of study participants were used to determined severity. Descriptive statistics and chi-square (X2) tests were used to assess bivariate relationships. Logistic regressions were used to model the likelihood of receiving a high or low stage and grade. The NLMS general population was the second dataset accessed to obtain a larger sample of prostate cancer mortality cases which were analyzed using Cox proportional hazard regression. There were over 50,000 black men in the study sample. The results of the study showed minor differences in the severity of prostate cancer between black men of low and high socioeconomic status. Education was the only variable that showed some significance for both stage and grade. Within-race differences were found between the socioeconomic status variables and mortality among black men. The lower the socioeconomic status, the greater the risk of mortality compared to those of higher socioeconomic status. While socioeconomic differences among black men did not explain the onset or severity of prostate cancer, it did provide some explanation for the high mortality. Much research is needed to assess other external factors such as access to medical care and prostate health education, discrimination, stress exposures, and social norms that might be related to the severity of and mortality from prostate cancer among black men.