Relationship between socioeconomic status and prostate cancer (incidence, aggressiveness, treatment with curative intent, and mortality): a spatial analysis using population-based cancer registry data.

ABSTRACT

BACKGROUND: Morbidity and mortality associated with prostate cancer in a given geographic area might be related to the level of socioeconomic deprivation. The Somme area (a region of northern France) is considered economically disadvantaged, with major territorial disparities. The aim of this study was to assess the impact of the socioeconomic level on prostate cancer, using data from a population-based cancer registry. METHODS: The source of data on cases of prostate cancer between 2006 and 2010 was the Somme cancer registry (Amiens, France). Socioeconomic status was measured according to the European Deprivation Index (EDI), which was used to classify each geographical "IRIS" unit (the smallest sub-municipal geographical entity for which French census data are available) according to its level of social deprivation. For spatial analysis, we considered a hierarchical generalized linear model. RESULTS: In the spatial analysis, prostate cancer incidence was higher in the less disadvantaged areas and treatment frequency with curative intent was lower in the most disadvantaged areas. Cancer aggressiveness and mortality were higher in the most disadvantaged areas relative risk (RR) = 1.36; 95% CI [1.09; 1.73] and RR=3.09 [1.70; 5.59], respectively. CONCLUSION: Our results evidenced a significant association between socioeconomic deprivation and prostate cancer, with worse outcomes among men with the lowest socioeconomic status.