Rizvi Nubaira, Hamilton Randy, Wu Xiao-Cheng, Celestin Michael D, Tseng Tung-Sung, Yu Qingzhao
Biostatistics and Data Science, School of Public Health, LSU Health-New Orleans, New Orleans, LA 70112, USA.
Louisiana Tumor Registry, School of Public Health, LSU Health-New Orleans, New Orleans, LA 70112, USA.
Curr Oncol. 2025 Jul 24;32(8):416. doi: 10.3390/curroncol32080416.
Prostate Cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer death among men. In Louisiana (LA), Black men are disproportionately diagnosed at later stages compared to White men. This study explores environmental risk factors as potential intermediate variables linking race to cancer diagnosis stage. The Louisiana Tumor Registry data included 24,647 male patients diagnosed with PCa in LA between 2010 and 2018. Among them, 15,875 (64.40%) were Caucasian American (CA) and 8772 (35.59%) African American (AA). Mediation analysis using multiple additive regression trees (MART) identified possible intermediate variables that potentially explain the observed disparity. The study found that individual characteristics and environmental factors jointly explained 84% (95% CI: 44.1%, 94.6%) and 18.6% (95% CI: 7.3%, 53.7%) of the observed racial disparity in PCa stage at diagnosis, respectively. Individual factors included BMI (35.9%), marital status (28.5%), CDI (8.2%), female-headed households (2.3%), comorbidity (3.9%), and insurance status (6.3%). Environmental contributors included cancer risk due to air toxicity exposure (7.2%), asthma prevalence (6.6%), acetaldehyde levels (2.1%), railroad proximity (2.1%), walkability (0.3%), and ozone level (-0.1%). Environmental factors jointly played a significant role in the observed racial disparity. The factors such as air toxicity, acetaldehyde levels, and asthma prevalence highlight the need to address industrial pollutants to reduce the differences.
前列腺癌（PCa）是男性中最常被诊断出的癌症，也是癌症死亡的第二大主要原因。在路易斯安那州（LA），与白人男性相比，黑人男性在晚期被诊断出患癌的比例过高。本研究探讨环境风险因素作为将种族与癌症诊断阶段联系起来的潜在中间变量。路易斯安那肿瘤登记数据包括2010年至2018年期间在LA被诊断出患有PCa的24,647名男性患者。其中，15,875名（64.40%）是美国白人（CA），8772名（35.59%）是非洲裔美国人（AA）。使用多重加法回归树（MART）进行的中介分析确定了可能解释观察到的差异的中间变量。研究发现，个体特征和环境因素分别解释了在诊断时PCa阶段观察到的种族差异的84%（95%CI：44.1%，94.6%）和18.6%（95%CI：7.3%，53.7%）。个体因素包括体重指数（35.9%）、婚姻状况（28.5%）、社区劣势指数（CDI）（8.2%）、女性为户主的家庭（2.3%）、合并症（3.9%）和保险状况（6.3%）。环境因素包括因接触空气毒性而导致的癌症风险（7.2%）、哮喘患病率（6.6%）、乙醛水平（2.1%）、铁路距离（2.1%）、步行便利性（0.3%）和臭氧水平（-0.1%）。环境因素在观察到的种族差异中共同发挥了重要作用。空气毒性、乙醛水平和哮喘患病率等因素凸显了应对工业污染物以减少差异的必要性。
