ASPO Abstracts
The impact of marital status on tumor aggressiveness and treatment among Black and White men diagnosed with prostate cancer in the North Carolina-Louisiana Prostate Cancer Project (PCaP)
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: To examine the association of marital status with tumor aggressiveness and receipt of definitive treatment in Black and White men from the North Carolina-Louisiana Prostate Cancer Project (PCaP).Methods: PCaP is a case-only, cross-sectional, population-based study among men diagnosed with incident prostate cancer. Black and White men were enrolled at an equal rate using a randomized recruitment method. Our study population consisted of 2080 men (1010 Black men; 1070 White men) from the PCaP cohort. Marital status at time of diagnosis was determined by self-report. High-aggressive tumors were defined using a composite measure of prostate-specific antigen (PSA), Gleason Score, and stage. Definitive treatment was defined as receipt of either radical prostatectomy or radiation. Multivariable logistic regression, was used to examine the association of marital status with high-aggressive tumors and receipt of definitive treatment. We adjusted for the following potential confounders: age, race, site, PSA or DRE (digital rectal exam) screening history, education, BMI, and tumor aggressiveness (definitive treatment model only). Results: Black men were less likely to be married than White men (68.1% vs. 83.6%). Overall, not being married (vs. married) was associated with increased odds of high-aggressive tumors (adjusted odds ratio (aOR): 1.56; 95% confidence interval (CI): 1.20, 2.02). In race-stratified analyses, not being married was associated with an increased odds of high-aggressive tumors in Black (aOR: 1.56; 95% CI: 1.14, 2.19) and White men (aOR: 1.59; 95% CI: 1.03, 2.44). Overall, unmarried men were less likely to receive definitive treatment (aOR: 0.68; 95% CI: 0.54, 0.85). In race stratified analyses, unmarried Black men were less likely to receive definitive treatment (aOR: 0.62; 95% CI: 0.47, 0.83), however, no association was observed in White men. Conclusion: Unmarried Black men are more likely to be diagnosed with high-aggressive tumors and less likely to receive definitive treatment. Lower rates of marriage among Black men could potentially contribute to lower levels of social support and exacerbate disparities. Providing additional support and education to unmarried men with prostate cancer could help reduce prostate cancer disparities.
Keywords: prostate cancer, marriage, social support