Socioeconomic status and the aggressiveness of prostate cancer among black men

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. 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: The linked Surveillance, Epidemiology, and Ends Results National, Longitudinal and Mortality Study (SEER NLMS) database and the NLMS general population dataset. Socioeconomic status was assessed and the stage and grade of prostate cancer from the medical histories of study participants were used to determined severity.  Mortality cases were analyzed using Cox proportional hazard regression model.

 Study results showed minor differences in the severity of prostate cancer between low and high SES black men.   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.

 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.  Attention should be focused on how to serve the black community to promote prostate health and mental health, and to motivate healthcare compliance.