Connection Between Neighborhood Disadvantage, Aggressive Prostate Cancer

Data show that of patients with prostate cancer, Black men face higher incidence and mortality rates than White men. Recent research has demonstrated that these increased rates may be due to neighborhood distress, chronic stress, and downstream biological effects.

A study from Joseph Boyle, PhD, and colleagues published in JAMA Network Open investigated the potential connection between neighborhood disadvantage metrics and prostate tumor RNA expression of stress-related genes.

The cross-sectional study evaluated prostate tumor transcriptomic data from Black and White men with prostate cancer who underwent radical prostatectomy between August 1992 and January 2021. Of the 218 patients, 168 (77%) were Black and 50 (23%) were White.

Dr. Boyle and colleagues reported that Black patients experienced more neighborhood disadvantage than White patients. They noted that the Area Deprivation Index was positively associated with expression for 11 genes, with HTR6 maintaining significance following multiple-comparison adjustment.

Multiple genes, including HTR6, related to several metrics. Increased expression of 5 proinflammatory genes in the Conserved Transcriptional Response to Adversity was linked to increased neighborhood disadvantage.

Investigators found that the sensitivity analysis for Black men only demonstrated similar results as the primary analysis featuring Black and White men. They also reported that insurance status was not a notable confounder for significant connections between neighborhood metrics and prostate tumor RNA expression of stress-related genes. There were minimal percentage changes in the coefficient for the neighborhood measures following adjustment for this variable.

“This study is one of the first to suggest associations of neighborhood disadvantage with prostate tumor RNA expression,” investigators wrote. “Additional research is needed in larger studies to replicate findings and further investigate interrelationships of neighborhood factors, tumor biology, and aggressive prostate cancer to inform interventions to reduce disparities.”