TABLE 2.
Prostate Cancer-Specific Mortality Hazard Ratios for African Americans vs. Non-Hispanic Whites Before and After Sequential Adjustment for Baseline Clinical Characteristics, Census Tract-Level Concentrated Disadvantage, and Healthcare Setting: 4 Chicago-Area Medical Centers, 1986–1990, with Follow-up Through 2006
| Model 1 | Model 2 | Model 3 | Model 4 | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Variables | HR | (95% CI) | p | HR | (95% CI) | p | HR | (95% CI) | p | HR | (95% CI) | p |
| Race/Ethnicity | ||||||||||||
| White, non-Hispanic (n=513) | 1.00 | 1.00 | (reference) | 1.00 | (reference) | 1.00 | (reference) | |||||
| African-American (n=320) | 1.58 | (1.15, 2.19) | .0051 | 1.30 | (1.09, 1.56) | .0036 | 0.98 | (0.83, 1.16) | .82 | 0.96 | (0.83, 1.11) | .61 |
| Tumor Characteristics | ||||||||||||
| Stage | ||||||||||||
| Local/Regional | 1.00 | (reference) | 1.00 | (reference) | 1.00 | (reference) | ||||||
| Distant/Unknown | 2.43 | (1.69, 3.48) | <.0001 | 2.42 | (1.70, 3.44) | <.0001 | 2.40 | (1.66, 3.46) | <.0001 | |||
| Differentiation | ||||||||||||
| Well | 1.00 | (reference) | 1.00 | (reference) | 1.00 | (reference) | ||||||
| Moderate | 1.46 | (0.97, 2.18) | .067 | 1.49 | (1.02, 2.16) | .037 | 1.52 | (1.07, 2.16) | .020 | |||
| Poor | 2.49 | (1.61, 3.84) | <.0001 | 2.59 | (1.74, 3.87) | <.0001 | 2.60 | (1.75, 3.86) | <.0001 | |||
| Age and Coexistent Illness | ||||||||||||
| Age, y | 1.00 | (0.99, 1.01) | .13 | 1.01 | (1.00, 1.01) | .0056 | 1.01 | (1.00, 1.01) | .021 | |||
| Charlson comorbidity score | 0.99 | (0.91, 1.07) | .72 | 0.98 | (0.91, 1.05) | .55 | 0.98 | (0.91, 1.05) | .55 | |||
| 1st-Course Treatment | ||||||||||||
| Surgery | 0.38 | (0.27, 0.54) | <.0001 | 0.38 | (0.27, 0.53) | <.0001 | 0.37 | (0.26, 0.53) | <.0001 | |||
| Radiation | 1.28 | (0.80, 2.03) | .30 | 1.30 | (0.84, 2.02) | .24 | 1.26 | (0.83, 1.94) | .28 | |||
| Castration | 2.05 | (1.40, 2.99) | .0002 | 2.05 | (1.40, 3.01) | .0002 | 2.03 | (1.39, 2.96) | .0003 | |||
| Diethylstilbesterol | 2.25 | (1.19, 4.25) | .013 | 2.20 | (1.06, 4.57) | .035 | 2.18 | (1.06, 4.47) | .033 | |||
| Observation only | 0.45 | (0.26, 0.81) | .0072 | 0.44 | (0.23, 0.82) | .0094 | 0.44 | (0.23, 0.84) | .013 | |||
| Experimental | 1.39 | (1.22, 1.59) | <.0001 | 1.39 | (1.18, 1.63) | <.0001 | 1.42 | (1.19, 2.71) | .0002 | |||
| Concentrated Disadvantage | ||||||||||||
| 1st Quartile (lowest) | 1.00 | (reference) | 1.00 | (reference) | ||||||||
| 2nd Quartile | 1.30 | (1.01, 1.66) | .036 | 1.44 | (1.19, 1.73) | .0002 | ||||||
| 3rd Quartile | 1.50 | (1.23, 1.83) | <.0001 | 1.55 | (1.14, 2.09) | .0049 | ||||||
| 4th Quartile (highest) | 1.77 | (1.20, 2.63) | .0043 | 2.37 | (1.76, 3.18) | <.0001 | ||||||
| p-trend | .0029 | <.0001 | ||||||||||
| Healthcare Setting | ||||||||||||
| Private Sector | 1.00 | (reference) | ||||||||||
| VHA | 1.93 | (1.23, 3.04) | .0046 | |||||||||
| Interaction Terms | ||||||||||||
| VHA*CD Quartile 1 | 1.00 | (reference) | ||||||||||
| VHA*CD Quartile 2 | 0.57 | (0.38, 0.88) | .011 | |||||||||
| VHA*CD Quartile 3 | 0.65 | (0.37, 1.14) | .13 | |||||||||
| VHA*CD Quartile 4 | 0.42 | (0.23, 0.76) | .0043 | |||||||||
Note: HR = hazard ratio; CI = confidence interval; VHA = Veterans Health Administration. Models 2 thru 4 are also adjusted for diagnosis year.