Abstract 809: Neighborhood disadvantage and prostate tumor aggressiveness among African American and European American men
Authors: Boyle Joseph , Yau Jessica , Slade Jimmie L. , Butts Derrick A. , Wimbush Jessica , Park Jong Y. , Hussain Arif , Onukwugha Eberechukwu , Knott Cheryl L. , Wheeler David C. , Barry Kathryn Hughes 
Published: March 2024

Introduction: African American (AA) men experience greater prostate cancer (PC) incidence and mortality compared to European American (EA) men, but the reasons are not fully understood. Some literature has identified connections between neighborhood disadvantage and aggressive PC, and AA men may be more likely to experience these factors than EA men. However, it is unclear if these associations may vary by race. We tested associations of two neighborhood disadvantage measures (neighborhood socioeconomic deprivation and racial segregation) with prostate tumor aggressiveness, overall and separately by race. We hypothesized that they would be positively associated and that associations would be stronger among AA men.

Methods: We leveraged data from the University of Maryland Greenebaum Comprehensive Cancer Center Tumor Registry for AA and EA men who were diagnosed with PC from 2004-2021. We geocoded participants’ addresses at diagnosis to determine census tract-based Area Deprivation Index (ADI) and Racial Isolation Index (RI) values. ADI analyses included men diagnosed in 2005 or later (778 AA men and 687 EA men), and RI analyses included men diagnosed in 2009 or later (606 AA men and 454 EA men) based on data availability. We used logistic regression to model the odds of aggressive PC, defined as a Gleason pattern of 4+3 or a total Gleason score &gt;=8, overall and by race. We fit models with scaled ADI or RI as the exposure variable, adjusting for race, age at diagnosis, and year of diagnosis. We also assessed an interaction between each neighborhood measure and race.

Results: Median (interquartile range) ADI scores were 118 (101-137) for AA men and 92 (83-102) for EA men, and RI scores were 0.68 (0.35-0.87) for AA men and 0.11 (0.06-0.20) for EA men, indicating greater neighborhood deprivation and AA residential segregation among AA participants. The greatest values for these scores were concentrated in central and west Baltimore. A one-standard deviation (SD) increase in ADI was associated with significantly greater odds of aggressive tumors for AA men (OR=1.28, 95% CI: 1.10, 1.49; p&lt;0.01), but not for EA men (OR=0.85, 95% CI: 0.67, 1.08; p=0.19), and the p-value for interaction (p&lt;0.01) was statistically significant. Similarly, a one-SD increase in RI was significantly associated with aggressive tumors for AA men (OR=1.24, 95% CI: 1.03, 1.49; p=0.03), but not for EA men (OR=1.23, 95% CI: 0.84, 1.80; p=0.29), although the p-value for interaction was not statistically significant.

Conclusions: Neighborhood disadvantage was significantly associated with higher odds of aggressive PC. The association of neighborhood deprivation and tumor aggressiveness was stronger among AA men. Additional analyses will consider other measures, including historical redlining, to further evaluate the relationship of neighborhood disadvantage with prostate tumor aggressiveness.

Citation Format: Joseph Boyle, Jessica Yau, Jimmie L. Slade, Derrick A. Butts, Jessica Wimbush, Jong Y. Park, Arif Hussain, Eberechukwu Onukwugha, Cheryl L. Knott, David C. Wheeler, Kathryn Hughes Barry. Neighborhood disadvantage and prostate tumor aggressiveness among African American and European American men [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 809.