Socioeconomic disadvantage but not remoteness affects short-term survival in prostate cancer: a population-based study using competing risks

Thomas, Audrey A. , Pearce, Alison, Sharp, Linda, Gardiner, Robert Alexander, Chambers, Suzanne, Aitken, Joanne, Molcho, Michal and Baade, Peter (2017) Socioeconomic disadvantage but not remoteness affects short-term survival in prostate cancer: a population-based study using competing risks. Asia Pacific Journal of Clinical Oncology, 13 2: e31-e40. doi:10.1111/ajco.12570


Author Thomas, Audrey A.
Pearce, Alison
Sharp, Linda
Gardiner, Robert Alexander
Chambers, Suzanne
Aitken, Joanne
Molcho, Michal
Baade, Peter
Title Socioeconomic disadvantage but not remoteness affects short-term survival in prostate cancer: a population-based study using competing risks
Journal name Asia Pacific Journal of Clinical Oncology   Check publisher's open access policy
ISSN 1743-7563
1743-7555
Publication date 2017-04-01
Year available 2016
Sub-type Article (original research)
DOI 10.1111/ajco.12570
Open Access Status Not yet assessed
Volume 13
Issue 2
Start page e31
End page e40
Total pages 10
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2018
Language eng
Formatted abstract
Aim: We examined how sociodemographic, clinical and area-level factors are related to short-term prostate cancer mortality versus mortality from other causes, a crucial distinction for this disease that disproportionately affects men older than 60 years.

Methods: We applied competing risk survival models to administrative data from the Queensland Cancer Registry (Australia) for men diagnosed with prostate cancer between January 2005 and July 2007, including stratification by Gleason score.

Results: The men (n = 7393) in the study cohort had a median follow-up of 5 years 3 months. After adjustment, remoteness and area-level disadvantage were not significantly associated with prostate cancer mortality. However, area-level disadvantage had a significant negative relationship with hazard of death from a cause other than prostate cancer within 7 years; compared with those living in the most advantaged areas, the likelihood of mortality was higher for those in the most disadvantaged (subhazard ratio [SHR] = 1.39; 95% CI, 1.01–1.90; P = 0.041), disadvantaged (SHR = 1.51; 95% CI, 1.14–2.00; P = 0.004), middle (SHR = 1.34; 95% CI, 1.02–1.75; P = 0.034) and advantaged areas (SHR = 1.44; 95% CI, 1.09–1.89; P = 0.009). Those with Gleason score of 7 and higher had a lower hazard of prostate cancer mortality if they were living with a partner, whereas those with lower Gleason scores and living a partner had lower hazards of other-cause mortality.

Conclusions: Understanding why men living in more disadvantaged areas have higher risk of non-prostate cancer mortality should be a priority.
Keyword Cause of death
Follow-up studies
Prostate cancer
Socioeconomic factors
Survival analysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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