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Cancer Causes Control. 2019 Sep;30(9):997-1007. doi: 10.1007/s10552-019-01196-w. Epub 2019 Jul 1.

Socioenvironmental adversity and risk of prostate cancer in non-Hispanic black and white men.

Author information

1
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA. kantore@mskcc.org.
2
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. kantore@mskcc.org.
3
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
4
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
5
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
6
Faculty of Medicine, Center of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
7
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
8
Department of African and African American Studies, Harvard University, Cambridge, MA, USA.
9
Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
10
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

Abstract

Non-Hispanic black (NHB) men experience higher risk of prostate cancer than other racial/ethnic groups, and it is possible that socioenvironmental (SE) adversity and resulting stress may contribute to this disparity. Data from the Southern Community Cohort Study were used to evaluate associations between SE adversity and perceived stress in relation to prostate cancer risk, overall and by race/ethnicity and grade. Between 2002 and 2009, 26,741 men completed a questionnaire, from which an 8-item SE adversity composite was created (covering socioeconomic status, residential environment, and social support/buffers). Two items from the Perceived Stress Scale were assessed. With follow-up through 2011, 527 prostate cancer cases were diagnosed. In multivariable models, each one-unit increase in the SE adversity composite was associated with increased prostate cancer risk among non-Hispanic white (NHW) men (HR 1.23; 95% CI 1.02-1.48) and reduced risk among NHB men (HR 0.89; 95% CI 0.82-0.95) (p interaction: 0.001). This pattern held for low grade, but not high grade, cancers although power was limited for the latter. Perceived stress variables were associated with increased risk of prostate cancer among NHW men, but not among NHB men. Results do not support the hypothesis that SE adversity my underlay the racial disparity in prostate cancer, over and above that of covariates, including healthcare utilization.

KEYWORDS:

African Americans; Life stress; Minority health; Prostate cancer; Psychological stress

PMID:
31264140
PMCID:
PMC6744283
[Available on 2020-09-01]
DOI:
10.1007/s10552-019-01196-w
[Indexed for MEDLINE]

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