Stage at diagnosis of prostate cancer in Connecticut by poverty and race.

OBJECTIVE

The study sought to determine if black-white differences in distribution of stage at diagnosis of prostate cancer persisted after controlling for a socioeconomic status (SES) indicator as an ecologic variable.

DESIGN

A descriptive epidemiologic study.

SETTING

The dataset was from the population-based Connecticut Tumor Registry (CTR), covering patients diagnosed in 1988-92.

PARTICIPANTS

All white (N = 8,155) and black (N = 521) patients diagnosed with prostate cancer and reported to the CTR.

RESULTS

The proportion of prostate cancers diagnosed at the distant (metastatic) stage was significantly higher in blacks than in whites, even within census tracts with high overall or race-specific poverty rates (20% or higher). When patient age and poverty rate of census tract (deciles) were included in a logistic model, black vs. white race was still statistically significantly associated with diagnosis at the distant vs. local or regional stage.

CONCLUSIONS

Further studies are needed to explore the potential roles of black-white differences in screening rates and in biological factors, independent of SES, in explaining these findings.