Journal article
The role of area-level influences on prostate cancer grade and stage at diagnosis
Preventive medicine, v 39(3), pp 441-448
2004
PMID: 15313082
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background. This research explores area-level social influences on prostate cancer, to test whether area-level influences explain disparities in U.S. prostate cancer burden.
Methods. The authors geocoded 23,993 1992–1997 Maryland prostate cancer cases, and linked cases to 1990 census data. The authors examined the effect of 17 area-level social variables, measured at block group, tract, and county, modeling individual and multilevel predictors of later stage and higher tumor grade.
Results. Younger age, black race, higher grade or ungraded tumors, and earlier year of diagnosis were associated with later stage. Block group percentage of white-collar workers (O.R. = 0.93, 95% C.I. = 0.89, 0.98), and county resources (O.R. = 0.94, 95% C.I. = 0.89, 0.98), were protective of later stage. Older age, black race, and earlier year of diagnosis were associated with higher grade. Block group income was protective for white men (O.R. = 0.92, 95% C.I. = 0.87, 0.96), but for all men, county resources increased risk of higher grade (O.R. = 1.23, 95% C.I. = 1.16, 1.31).
Conclusions. Social resources did not significantly reduce racial differences. Results suggest tumor biology is related to relative resources, with better outcomes associated with greater small-area wealth in low-resource counties, but stage at diagnosis is associated with absolute resources, with better outcomes associated with higher small-area social class in high-resource counties.
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Details
- Title
- The role of area-level influences on prostate cancer grade and stage at diagnosis
- Creators
- Ann C Klassen - Department of Health Policy and Management, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USAFrank C Curriero - Department of Biostatistics, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USAJean Hee Hong - Department of Health Policy and Management, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USAChyvette Williams - Department of Health Policy and Management, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USAMartin Kulldorff - Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02115, USAHelen I Meissner - The National Cancer Institute, The National Institutes of Health, Bethesda, MD 20892, USAAnthony Alberg - Department of Epidemiology, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USAMargaret Ensminger - Department of Health Policy and Management, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
- Publication Details
- Preventive medicine, v 39(3), pp 441-448
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Community Health and Prevention
- Web of Science ID
- WOS:000223760000002
- Scopus ID
- 2-s2.0-4143071338
- Other Identifier
- 991014877717104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health