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  1. Article ; Online: Relative impact of genetic ancestry and neighborhood socioeconomic status on all-cause mortality in self-identified African Americans.

    Iyer, Hari S / Gomez, Scarlett Lin / Cheng, Iona / Rebbeck, Timothy R

    PloS one

    2022  Volume 17, Issue 8, Page(s) e0273735

    Abstract: Self-identified race/ethnicity is a correlate of both genetic ancestry and socioeconomic factors, both of which may contribute to racial disparities in mortality. Investigators often hold a priori assumptions, rarely made explicit, regarding the relative ...

    Abstract Self-identified race/ethnicity is a correlate of both genetic ancestry and socioeconomic factors, both of which may contribute to racial disparities in mortality. Investigators often hold a priori assumptions, rarely made explicit, regarding the relative importance of these factors. We studied 2,239 self-identified African Americans (SIAA) from the Prostate, Lung, Colorectal and Ovarian screening trial enrolled from 1993-1998 and followed prospectively until 2019 or until death, whichever came first. Percent African genetic ancestry was estimated using the GRAF-Pop distance-based method. A neighborhood socioeconomic status (nSES) index was estimated using census tract measures of income, housing, and employment and linked to participant residence in 2012. We used Directed Acyclic Graphs (DAGs) to represent causal models favoring (1) biomedical and (2) social causes of mortality. Hazard ratios were estimated using Cox models adjusted for sociodemographic, behavioral, and neighborhood covariates guided by each DAG. 901 deaths occurred over 40,767 person-years of follow-up. In unadjusted (biomedical) models, a 10% increase in percent African ancestry was associated with a 7% higher rate of all-cause mortality (HR: 1.07, 95% CI: 1.02, 1.12). This effect was attenuated in covariate adjusted (social) models (aHR: 1.01, 95% CI: 0.96, 1.06). Mortality was lower comparing participants in the highest to lowest nSES quintile following adjustment for covariates and ancestry (aHR: 0.74, 95% CI: 0.57, 0.98, Ptrend = 0.017). Higher African ancestry and lower nSES were associated with higher mortality, but African ancestry was not associated with mortality following covariate adjustment. Socioeconomic factors may be more important drivers of mortality in African Americans.
    MeSH term(s) African Americans/genetics ; Ethnicity ; Humans ; Male ; Residence Characteristics ; Social Class ; Socioeconomic Factors
    Language English
    Publishing date 2022-08-29
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0273735
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Racial differences in postpandemic trends in prostate-specific antigen screening.

    Qian, Zhiyu / Alexander, Jameshisa / Daniels, Danesha / Abdollah, Firas / Cole, Alexander P / Iyer, Hari S / Trinh, Quoc-Dien

    JNCI cancer spectrum

    2024  Volume 8, Issue 2

    Abstract: Our study investigates the trends in prostate cancer screening amid the COVID-19 pandemic, particularly focusing on racial disparities between Black and White men. Utilizing data from the Behavioral Risk Factor Surveillance System from 2018, 2020, and ... ...

    Abstract Our study investigates the trends in prostate cancer screening amid the COVID-19 pandemic, particularly focusing on racial disparities between Black and White men. Utilizing data from the Behavioral Risk Factor Surveillance System from 2018, 2020, and 2022, we analyzed prostate-specific antigen screening rates in men aged 45-75 years. Our findings reveal initial declines in screening rates for both groups during the pandemic, with subsequent recovery; however, the pace of rebound differed statistically significantly between races. Whereas White men showed a notable increase in screening rates postpandemic, Black men's rates recovered more slowly. This disparity underscores the impact of socioeconomic factors, health-care access, and possibly systemic biases affecting health-care delivery. Our study highlights the need for targeted interventions to address these inequalities and ensure equitable access to prostate cancer preventive care in the aftermath of COVID-19.
    MeSH term(s) Male ; Humans ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/epidemiology ; Early Detection of Cancer ; Pandemics ; Race Factors ; COVID-19/epidemiology
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2024-03-28
    Publishing country England
    Document type Journal Article
    ISSN 2515-5091
    ISSN (online) 2515-5091
    DOI 10.1093/jncics/pkae016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Climate change perception and its association with cancer screening intent.

    Qian, Zhiyu / Beatrici, Edoardo / Trinh, Quoc-Dien / Kibel, Adam S / Loeb, Stacy / Iyer, Hari S / Cole, Alexander P

    Journal of the National Cancer Institute

    2024  Volume 116, Issue 4, Page(s) 618–622

    Abstract: As the climate crisis deepens, its adverse effects on human health are becoming evident, including impacts on cancer pathogenesis and treatment. This study explored the link between individuals' awareness of the health impacts of climate change and ... ...

    Abstract As the climate crisis deepens, its adverse effects on human health are becoming evident, including impacts on cancer pathogenesis and treatment. This study explored the link between individuals' awareness of the health impacts of climate change and interest in cancer screening. Using the 2021 Health Information National Trends Survey, our study demonstrated a statistically significant association between recognition of climate change as a personal health threat and interest in cancer screening. Although the study's retrospective nature and self-reported data pose some limitations, these findings signal a promising avenue for future research on the intersection of climate and cancer risk. This research supports the development of public health interventions that incorporate components of environmental health literacy alongside cancer screening efforts.
    MeSH term(s) Humans ; Early Detection of Cancer ; Climate Change ; Retrospective Studies ; Perception ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Neoplasms/etiology
    Language English
    Publishing date 2024-03-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2992-0
    ISSN 1460-2105 ; 0027-8874 ; 0198-0157
    ISSN (online) 1460-2105
    ISSN 0027-8874 ; 0198-0157
    DOI 10.1093/jnci/djad237
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  4. Article ; Online: Comparing patient-reported outcomes and lifestyle factors before and after the COVID-19 pandemic among Black and Hispanic breast cancer survivors in New Jersey.

    Sánchez-Díaz, Carola T / Zeinomar, Nur / Iyer, Hari S / Perlstein, Marley / Gonzalez, Brian D / Hong, Chi-Chen / Bandera, Elisa V / Qin, Bo

    Journal of cancer survivorship : research and practice

    2024  

    Abstract: Purpose: The impact of the COVID-19 pandemic restrictions in the US since March 2020 on cancer survivorship among Black and Hispanic breast cancer (BC) survivors remains largely unknown. We aimed to evaluate associations of the pandemic with participant ...

    Abstract Purpose: The impact of the COVID-19 pandemic restrictions in the US since March 2020 on cancer survivorship among Black and Hispanic breast cancer (BC) survivors remains largely unknown. We aimed to evaluate associations of the pandemic with participant characteristics, patient-reported outcomes (PROs), and lifestyle factors among Black and Hispanic BC survivors in the Women's Circle of Health Follow-Up Study and the New Jersey BC Survivors Study.
    Methods: We included 447 Black (n
    Results: Hispanic and Black BC survivors recruited after the onset of the pandemic reported higher socioeconomic status and fewer comorbidities. Black women in the post-pandemic group reported a higher prevalence of clinically significant sleep disturbance (prevalence ratio (PR) 1.43, 95% CI 1.23, 1.68), lower sleep efficiency, and lower functional well-being, compared to the pre-pandemic group. Hispanic women were less likely to report low health-related quality of life (vs. high; PR 0.62, 95% CI 0.45, 0.85) after the onset of the pandemic.
    Conclusions: Ongoing research is crucial to untangle the impact of the pandemic on racial and ethnic minorities participating in cancer survivorship research, as well as PROs and lifestyle factors.
    Implications for cancer survivors: This study highlights the importance of considering the impact of the pandemic in all aspects of research, including the interpretation of findings.
    Language English
    Publishing date 2024-04-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2388888-X
    ISSN 1932-2267 ; 1932-2259
    ISSN (online) 1932-2267
    ISSN 1932-2259
    DOI 10.1007/s11764-024-01575-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Comparing absolute and relative distance and time travel measures of geographic access to healthcare facilities in rural Haiti.

    Bhangdia, Kayleigh Pavitra / Iyer, Hari S / Joseph, Jean Paul / Dorne, Rubin Lemec / Mukherjee, Joia / Fadelu, Temidayo

    BMJ open

    2022  Volume 12, Issue 5, Page(s) e056123

    Abstract: Introduction: While travel distance and time are important proxies of physical access to health facilities, obtaining valid measures with an appropriate modelling method remains challenging in many settings. We compared five measures of geographic ... ...

    Abstract Introduction: While travel distance and time are important proxies of physical access to health facilities, obtaining valid measures with an appropriate modelling method remains challenging in many settings. We compared five measures of geographic accessibility in Haiti, producing recommendations that consider available analytic resources and geospatial goals.
    Methods: Eight public hospitals within the ministry of public health and population were included. We estimated distance and time between hospitals and geographic centroids of Haiti's section communes and population-level accessibility. Geographic feature data were obtained from public administrative databases, academic research databases and government satellites. We used validated geographic information system methods to produce five geographic access measures: (1) Euclidean distance (ED), (2) network distance (ND), (3) network travel time (NTT), (4) AccessMod 5 (AM5) distance (AM5D) and (5) AM5 travel time (AM5TT). Relative ranking of section communes across the measures was assessed using Pearson correlation coefficients, while mean differences were assessed using analysis of variance (ANOVA) and pairwise t-tests.
    Results: All five geographic access measures were highly correlated (range: 0.78-0.99). Of the distance measures, ED values were consistently the shortest, followed by AM5D values, while ND values were the longest. ND values were as high as 2.3 times ED values. NTT models generally produced longer travel time estimates compared with AM5TT models. ED consistently overestimated population coverage within a given threshold compared with ND and AM5D. For example, population-level accessibility within 15 km of the nearest studied hospital in the Center department was estimated at 68% for ED, 50% for AM5D and 34% for ND.
    Conclusion: While the access measures were highly correlated, there were significant differences in the absolute measures. Consideration of the benefits and limitations of each geospatial measure together with the intended purpose of the estimates, such as relative proximity of patients or service coverage, are key to guiding appropriate use.
    MeSH term(s) Haiti ; Health Facilities ; Health Services Accessibility ; Humans ; Rural Population ; Travel
    Language English
    Publishing date 2022-05-24
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-056123
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  6. Article ; Online: Proximity to Alcohol Sellers and Dose Response Relationship Between Alcohol Consumption With Intimate Partner Violence in Rural Southwestern Uganda.

    Ohurira, Tushaba / Iyer, Hari S / Wagman, Jennifer A / Hahn, Judith A / Bajunirwe, Francis

    Journal of interpersonal violence

    2022  Volume 38, Issue 1-2, Page(s) NP1040–NP1059

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Male ; Female ; Humans ; Adult ; Rural Population ; Sexual Partners ; Cross-Sectional Studies ; Alcoholism ; Uganda/epidemiology ; Intimate Partner Violence ; Prevalence ; Risk Factors ; Ethanol ; Alcohol Drinking/epidemiology
    Chemical Substances Ethanol (3K9958V90M)
    Language English
    Publishing date 2022-04-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2028900-5
    ISSN 1552-6518 ; 0886-2605
    ISSN (online) 1552-6518
    ISSN 0886-2605
    DOI 10.1177/08862605221086648
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  7. Article ; Online: Association of Variation in US County-Level Rates of Liver Surgical Resection for Colorectal Liver Metastasis With Poverty Rates in 2010.

    Molina, George / Ruan, Mengyuan / Lipsitz, Stuart R / Iyer, Hari S / Hassett, Michael J / Brindle, Mary E / Trinh, Quoc-Dien

    JAMA network open

    2023  Volume 6, Issue 2, Page(s) e230797

    Abstract: Importance: Among patients with colorectal liver metastasis (CRLM) who are eligible for curative-intent liver surgical resection, only half undergo liver metastasectomy. It is currently unclear how rates of liver metastasectomy vary geographically in ... ...

    Abstract Importance: Among patients with colorectal liver metastasis (CRLM) who are eligible for curative-intent liver surgical resection, only half undergo liver metastasectomy. It is currently unclear how rates of liver metastasectomy vary geographically in the US. Geographic differences in county-level socioeconomic characteristics may, in part, explain variability in the receipt of liver metastasectomy for CRLM.
    Objective: To describe county-level variation in the receipt of liver metastasectomy for CRLM in the US and its association with poverty rates.
    Design, setting, and participants: This ecological, cross-sectional, and county-level analysis was conducted using data from the Surveillance, Epidemiology, and End Results Research Plus database. The study included the county-level proportion of patients who had colorectal adenocarcinoma diagnosed between January 1, 2010, and December 31, 2018, underwent primary surgical resection, and had liver metastasis without extrahepatic metastasis. The county-level proportion of patients with stage I colorectal cancer (CRC) was used as a comparator. Data analysis was performed on March 2, 2022.
    Exposures: County-level poverty in 2010 obtained from the US Census (proportion of county population below the federal poverty level).
    Main outcomes and measures: The primary outcome was county-level odds of liver metastasectomy for CRLM. The comparator outcome was county-level odds of surgical resection for stage I CRC. Multivariable binomial logistic regression accounting for clustering of outcomes within a county via an overdispersion parameter was used to estimate the county-level odds of receiving a liver metastasectomy for CRLM associated with a 10% increase in poverty rate.
    Results: In the 194 US counties included in this study, there were 11 348 patients. At the county level, the majority of the population was male (mean [SD], 56.9% [10.2%]), White (71.9% [20.0%]), and aged between 50 and 64 (38.1% [11.0%]) or 65 and 79 (33.6% [11.4%]) years. The adjusted odds of undergoing a liver metastasectomy was lower in counties with higher poverty in 2010 (per 10% increase; odds ratio, 0.82 [95% CI, 0.69-0.96]; P = .02). County-level poverty was not associated with receipt of surgery for stage I CRC. Despite the difference in rates of surgery (mean county-level rates were 0.24 for liver metastasectomy for CRLM and 0.75 for surgery for stage I CRC), the variance at the county-level for these 2 surgical procedures was similar (F370, 193 = 0.81; P = .08).
    Conclusions and relevance: The findings of this study suggest that higher poverty was associated with lower receipt of liver metastasectomy among US patients with CRLM. Surgery for a more common and less complex cancer comparator (ie, stage I CRC) was not observed to be associated with county-level poverty rates. However, county-level variation in surgical rates was similar for CRLM and stage I CRC. These findings further suggest that access to surgical care for complex gastrointestinal cancers such as CRLM may be partially influenced by where patients live.
    MeSH term(s) Humans ; Male ; Middle Aged ; Cross-Sectional Studies ; Liver Neoplasms/surgery ; Poverty ; Colorectal Neoplasms/surgery
    Language English
    Publishing date 2023-02-01
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.0797
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  8. Article ; Online: Geographic Accessibility of Radiation Therapy Facilities in Sub-Saharan Africa.

    Nadella, Pranay / Iyer, Hari S / Manirakiza, Achille / Vanderpuye, Verna / Triedman, Scott A / Shulman, Lawrence N / Fadelu, Temidayo

    International journal of radiation oncology, biology, physics

    2023  Volume 115, Issue 3, Page(s) 557–563

    Abstract: Purpose: Access to radiation therapy in Sub-Saharan Africa (SSA) remains unacceptably low. Prior studies have focused on how many radiation therapy machines a country has but have not accounted for geographic accessibility, which is a known barrier to ... ...

    Abstract Purpose: Access to radiation therapy in Sub-Saharan Africa (SSA) remains unacceptably low. Prior studies have focused on how many radiation therapy machines a country has but have not accounted for geographic accessibility, which is a known barrier to radiation therapy compliance. In this study, we describe accessibility measured as travel time by road to radiation therapy in SSA.
    Methods and materials: This study used geographic information systems modeling techniques. A list of radiation therapy facilities was obtained from the Directory of Radiotherapy Centres. We obtained a 1 km
    Results: Only 24.4% of the population of SSA can access a radiation therapy facility within 2 hours of travel by road; access was 14.6% and 42.5% within 1 and 4 hours, respectively. More than 80% of Rwandans and South Africans were within 2 hours of radiation therapy, the highest in the region. Although countries with more radiation therapy units per capita tended to have higher 2-hour access, there was notable discordance between the 2 measures. Mauritania, Zambia, Sudan, and Namibia were among the top 10 countries ranked by machines per capita, but none ranked in the top 10 by 2-hour geographic access. There was similar discordance between 2-hour access and radiation therapy units per cancer case; Rwanda, Nigeria, Senegal, and Cote d'Ivoire ranked in the top 10 for the former but ranked worse using units per cancer case.
    Conclusions: Prior measures of radiation therapy access provide an incomplete picture. Geographic location of radiation therapy centers is a crucial component of access that should be considered for future planning in SSA.
    MeSH term(s) Humans ; Radiation Oncology ; Africa South of the Sahara ; Travel ; World Health Organization ; Neoplasms/radiotherapy ; Health Services Accessibility
    Language English
    Publishing date 2023-02-01
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2022.10.018
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  9. Article ; Online: Prostate-specific antigen testing rates in high-risk populations: results from the All of Us Research Program.

    Morley, Faith / Iyer, Hari S / Tamimi, Rulla M / Nanus, David M / Rebbeck, Timothy R / Kensler, Kevin H

    Cancer causes & control : CCC

    2023  Volume 35, Issue 3, Page(s) 509–521

    Abstract: Background: Early detection of prostate cancer using prostate-specific antigen (PSA) remains controversial and disparities in the receipt of prostate cancer screening persist in the US. We sought to examine disparities in PSA testing rates among groups ... ...

    Abstract Background: Early detection of prostate cancer using prostate-specific antigen (PSA) remains controversial and disparities in the receipt of prostate cancer screening persist in the US. We sought to examine disparities in PSA testing rates among groups with higher prostate cancer risk and differential access to healthcare.
    Methods: We identified a cohort of 37,706 males within the All of Us Research Program without a history of prostate cancer between the ages of 40 and 85 at time of enrollment (2017-2021). Incidence rate ratios (IRR) for the number of PSA tests received during follow-up through December 2021 were estimated using age- and multivariable-adjusted negative binomial regression models. PSA testing frequencies in the cohort were compared with population-based estimates from the 2020 Behavioral Risk Factor Surveillance System (BRFSS).
    Results: A total of 6,486 males (17.2%) received at least one PSA test over the course of follow-up. In multivariable-adjusted models, non-Hispanic Black males received PSA tests at a 17% lower rate (IRR = 0.83, 95% CI 0.76, 0.90) than non-Hispanic White males. Higher educational attainment, higher annual income, having self-/employer-purchased insurance, having a spouse or domestic partner, and having a family history of prostate cancer were all associated with higher rates of PSA testing. The proportion of males ages 55 to 69 who received a PSA test within two years was lower in All of Us (12.4%, 95% CI 11.8-13.0%) relative to population-based estimates from the BRFSS (35.2%, 95% CI 34.2-36.3%).
    Conclusion: Absolute PSA testing rates in All of Us were lower than population-based estimates, but associations with PSA testing in the cohort mirrored previously reported disparities in prostate cancer screening. These findings highlight the importance of addressing barriers to care in order to reduce disparities in cancer screening.
    MeSH term(s) Male ; Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/epidemiology ; Early Detection of Cancer/methods ; Population Health ; Ethnicity ; Mass Screening
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2023-10-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1064022-8
    ISSN 1573-7225 ; 0957-5243
    ISSN (online) 1573-7225
    ISSN 0957-5243
    DOI 10.1007/s10552-023-01807-7
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  10. Article ; Online: Trends in mortality among Black and White men with prostate cancer in Massachusetts and Pennsylvania: Race and neighborhood socioeconomic position.

    Iyer, Hari S / Gomez, Scarlett L / Chen, Jarvis T / Trinh, Quoc-Dien / Rebbeck, Timothy R

    Cancer

    2021  Volume 127, Issue 14, Page(s) 2525–2534

    Abstract: Background: Reducing disparities in men with prostate cancer (PCa) that may be caused by racial and socioeconomic differences is a major public health priority. Few reports have studied whether these disparities have changed over time.: Methods: Men ... ...

    Abstract Background: Reducing disparities in men with prostate cancer (PCa) that may be caused by racial and socioeconomic differences is a major public health priority. Few reports have studied whether these disparities have changed over time.
    Methods: Men diagnosed with PCa from January 1, 2000 to December 31, 2015 were identified from the Massachusetts and Pennsylvania cancer registries. All-cause mortality and PCa and cardiovascular cause-specific mortality were assessed. To estimate neighborhood socioeconomic position (nSEP), a summary score was generated using census tract-level measures of income, wealth, educational attainment, and racial and income segregation. Participants were grouped by diagnosis year (2000-2003, 2004-2007, 2008-2011, or 2012-2015), and changing trends in the mortality rate ratio by race and nSEP were estimated using covariate-adjusted Cox models with follow-up for up to 10 years, until death, or until censoring on January 1, 2018.
    Results: There were 193,883 patients with PCa and 43,661 deaths over 1,404,131 person-years of follow-up. The Black-White adjusted hazard ratio (aHR) from 2000 to 2003 through 2012 to 2015 was stable for all-cause mortality (aHR, 1.14 to 0.97; P for heterogeneity = .42), decreased for PCa-specific mortality (aHR, 1.38 to 0.93; P for heterogeneity = .005), and increased for cardiovascular mortality (aHR, 1.09 to 1.28; P for heterogeneity = .034). The aHR comparing those in the lowest versus the highest nSEP quintile increased significantly for all-cause mortality (aHR, 1.54 to 1.79; P for heterogeneity = .008), but not for PCa-specific mortality (aHR, 1.60 to 1.72; P for heterogeneity = .40) or cardiovascular mortality (aHR, 1.72 to 1.89; P for heterogeneity = .085).
    Conclusions: Although Black-White disparities in prostate mortality declined in Massachusetts and Pennsylvania over the study period, nSEP mortality disparity trends were stagnant or increased, warranting further attention.
    Lay summary: Few reports have examined whether racial and socioeconomic disparities in prostate cancer mortality have widened or narrowed in recent years. Using data from 2 state registries (Massachusetts and Pennsylvania) with differing intensities of government-mandated health insurance, trends in racial and neighborhood socioeconomic disparities were studied among Black and White men diagnosed from 2000 to 2015. Overall, trends in racial disparities were stagnant for all-cause mortality, shrank for prostate mortality, and widened for cardiovascular mortality. Disparities associated with neighborhood socioeconomic status either were stagnant or widened across all mortality end points. In general, disparities were more pronounced in Pennsylvania than in Massachusetts.
    MeSH term(s) Black or African American ; Humans ; Male ; Pennsylvania/epidemiology ; Prostatic Neoplasms ; Social Class ; Socioeconomic Factors ; White People
    Language English
    Publishing date 2021-04-02
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.33506
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