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Socioeconomic status, healthcare density, and risk of prostate cancer among African American and Caucasian men in a large prospective study
Family Medicine and Community Health Publications and Presentations
  • Jacqueline M. Major, National Cancer Institute
  • M. Norman Oliver, University of Virginia School of Medicine
  • Chyke A. Doubeni, University of Massachusetts Medical School
  • Albert R. Hollenbeck, AARP
  • Barry I. Graubard, National Cancer Institute
  • Rashmi Sinha, National Cancer Institute
UMMS Affiliation
Department of Family Medicine and Community Health; Meyers Primary Care Institute
Publication Date
Document Type
Prostatic Neoplasms; Prospective Studies

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.

DOI of Published Version

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

Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Jacqueline M. Major, M. Norman Oliver, Chyke A. Doubeni, Albert R. Hollenbeck, et al.. "Socioeconomic status, healthcare density, and risk of prostate cancer among African American and Caucasian men in a large prospective study" Vol. 23 Iss. 7 (2012) ISSN: 0957-5243 (Linking)
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