Abstract LB-277: Socioeconomic status and the aggressiveness of prostate cancer among black males
Authors: Percy-Laurry Antoinette 
Published: August 2015

Abstract
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. Black men have 58% higher risk of developing prostate cancer and almost 150% higher risk of mortality from prostate cancer, compared to white men. Little is known about the cause of the disease and uncovering the causes of the disparities remains challenging. One possible contributing factor are differences in socioeconomic status (SES).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 SES within the black race.
Two datasets were used in this study. A total of 715 black men with a diagnosis of prostate cancer were studied using individual-level data from the linked Surveillance, Epidemiology, and Ends Results National, Longitudinal and Mortality Study (SEER NLMS) database. Socioeconomic status was assessed and the stage and grade of prostate cancer from the medical histories of study participants were used to determined severity. 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 second dataset, the NLMS general population, was also accessed to obtain a larger sample of prostate cancer mortality cases which were analyzed using Cox proportional hazard regression model. There were 50,576 black men in this study sample.
Study results showed minor differences in the severity of prostate cancer between low and high SES black men. Lower income was associated with higher grade. Poverty showed no association with aggressive prostate cancer. Education was the only variable that showed some significance for both stage and grade. Having some college seems to be protective; however, the association was weak. Within race differences between SES variables and mortality among black men were found. The lower the SES the less likely the mortality compared to those of higher SES. Higher risk of mortality among the less educated and those with low income persists.
In conclusion, this study found that SES is not associated with the risk of severe prostate cancer incidence but is associated with mortality among black men. There seems to be a link among black men that may help to explain the disparities with other races. Commonalities in lifestyle factors such as environmental stressors and dietary choices may explain the onset of the disease across SES categories. Access to health education and healthcare for preventive and treatment services is paramount for survival. In addition, much research is needed to assess other external factors such as discrimination, stress exposures and social norms that may play a part. Finally, attention should be focused on how to serve the black community to promote prostate health and mental health, and to motivate healthcare compliance.
Citation Format: Antoinette Percy-Laurry. Socioeconomic status and the aggressiveness of prostate cancer among black males. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-277. doi:10.1158/1538-7445.AM2015-LB-277