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. 2010 Jun;19(6):1460-7.
doi: 10.1158/1055-9965.EPI-09-1310. Epub 2010 May 25.

Spatial patterns of localized-stage prostate cancer incidence among white and black men in the southeastern United States, 1999-2001

Sean F Altekruse  1 , Lan Huang, James E Cucinelli, Timothy S McNeel, Kristen M Wells, M Norman Oliver
Affiliations

Spatial patterns of localized-stage prostate cancer incidence among white and black men in the southeastern United States, 1999-2001

Sean F Altekruse et al. Cancer Epidemiol Biomarkers Prev. 2010 Jun.

Abstract

Background: In the United States, prostate cancer incidence is higher among black than among white males, with a higher proportion of blacks diagnosed with advanced-stage cancer.

Methods: Prostate cancer incidence (1999-2001) and census tract data were obtained for 66,468 cases in four states that account for 20% of U.S. blacks: Georgia, Florida, Alabama, and Tennessee. Spatial clusters of localized-stage prostate cancer incidence were detected by spatial scan. Clusters were examined by relative risk, population density, and socioeconomic and racial attributes.

Results: Overall prostate cancer incidence rates were higher in black than in white men, and a lower proportion of black cases were diagnosed with localized-stage cancer. Strong associations were seen between urban residence and high relative risk of localized-stage cancer. The highest relative risks generally occurred in clusters with a lower percent black population than the national average. Conversely, of eight nonurban clusters with significantly elevated relative risk of localized-disease, seven had a higher proportion of blacks than the national average. Furthermore, positive correlations between percent black population and relative risk of localized-stage cancer were seen in Alabama and Georgia.

Conclusion: Association between urban residence and high relative risk of localized-stage disease (favorable prognosis) persisted after spatial clusters were stratified by percent black population. Unexpectedly, seven of eight nonurban clusters with high relative risk of localized-stage disease had a higher percentage of blacks than the U.S. population.

Impact: Although evidence of racial disparity in prostate cancer was found, there were some encouraging findings. Studies of community-level factors that might contribute to these findings are recommended.

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Figures

Figure 1
Figure 1
Multistate analysis of spatial clusters with statistically significant relative risks of localized-stage prostate cancer compared to the background incidence rate - Tennessee, Alabama, Georgia, and Florida: 1999 to 2001* * Cases restricted to Black and white males only
Figure 2
Figure 2
Spatial clusters with statistically significant relative risk of localized-stage prostate cancer compared to the background incidence rate by individual state – Alabama, Florida, Georgia, and Tennessee: 1999–2001 * Cases restricted to Black and white males only
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