Association of neighborhood gentrification with prostate cancer and immune markers in African American and European American men

Abstract

Background: Prior studies showed that neighborhood deprivation increases the risk of lethal prostate cancer. However, the role of neighborhood gentrification in prostate cancer development and outcome remains poorly understood. We examined the relationships of gentrification with prostate cancer and serum proteome-defined inflammation and immune function in a diverse cohort.

Methods: The case-control study included 769 cases [405 African American (AA), 364 European American (EA) men] and 1023 controls (479 AA and 544 EA), with 219 all-cause and 59 prostate cancer-specific deaths among cases. Geocodes were linked to a neighborhood gentrification index (NGI) derived from US Census data. Cox and logistic regression, and MANOVA, were used to determine associations between NGI, as continuous or quintiles (Q), and outcomes.

Results: Adjusting for individual socioeconomic status (SES), continuous NGI was positively associated with prostate cancer among all men (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14). AA and low-income men experienced the highest odds of prostate cancer when residing in tracts with moderate gentrification, whereas EA men experienced reduced odds of regional/metastatic cancer with increased gentrification in SES-adjusted analyses. Continuous NGI also associated with mortality among men presenting with localized disease and low-income men in SES-adjusted Cox regression analyses. NGI was not associated with serum proteome-defined chemotaxis, inflammation, and tumor immunity suppression.

Conclusions: Findings show that neighborhood gentrification associates with prostate cancer and mortality in this diverse population albeit associations were heterogenous within subgroups. The observations suggest that changing neighborhood socioeconomic environments may affect prostate cancer risk and outcome, likely through multifactorial mechanisms.

Keywords: health disparity; immune markers; minority and vulnerable populations; mortality; neighborhood; prostate cancer.

FIGURE 1

Association of neighborhood gentrification with a prostate cancer diagnosis among African American (AA) and European American (EA) men. Odds ratios (OR) and 95% confidence interval (CI) for a prostate cancer diagnosis by neighborhood gentrification with gentrification coded as (A) continuous score and (B) quintiles, with additional stratification by self‐reported race/ethnicity. Logistic regression with Model 1 being adjusted for all baseline covariates, whereas Model 2 adjusted for all covariates with the additional inclusion of education and individual income.

FIGURE 2

Association of neighborhood gentrification with a prostate cancer diagnosis stratified by income. Odds ratios (OR) and 95% confidence interval (CI) for a prostate cancer diagnosis by neighborhood gentrification with gentrification coded as (A) continuous score and (B) quintiles, with additional stratification by self‐reported income. Low income = <$30,000, high income = ≥$30,000. Logistic regression with Model 1 being adjusted for all baseline covariates, whereas Model 2 adjusted for all covariates with the additional inclusion of education.