Identifying Risk Profiles of Malignant Prostate Cancer Surgical Delay Using a Person-Centered Approach to Understand Prostate Cancer Disparities: The Constellation of Health Determinants Using Latent Class Analysis on Cancer Registry Data

• Type of Material: Article
• Authors: Francisco A Montiel Ishino, National Institute on Minority Health and Health Disparities, NIH, Bethesda; Claire Rowan, Emory University; Rina Das, National Institute on Minority Health and Health Disparities, NIH, Bethesda; Janani Thapa, University of Georgia, Athens; Ewan Cobran, University of Georgia, Athens; Martin Whiteside, Tennessee Department of Health; Faustine Williams, National Institute on Minority Health and Health Disparities, NIH, Bethesda
• Language: English
• Date: 2020-12-29
• Publisher: SAGE Publications (UK and US)
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2020
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1177/1557988320984282
• Title of Journal or Parent Work: American Journal of Mens Health
• Volume: 14
• Issue: 6
• Grant/Funding Information: The author(s) received no financial support for the research, authorship, and/or publication of this article.
• Keywords: surgical treatment delay; prostate cancer; latent class analysis; health disparities
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Health Care Management

Abstract

Surgical prostate cancer (PCa) treatment delay (TD) may increase the likelihood of recurrence of disease, and influence quality of life as well as survival disparities between Black and White men. We used latent class analysis (LCA) to identify risk profiles in localized, malignant PCa surgical treatment delays while assessing co-occurring social determinants of health. Profiles were identified by age, marital status, race, county of residence (non-Appalachian or Appalachian), and health insurance type (none/self-pay, public, or private) reported in the Tennessee Department of Health cancer registry from 2005 to 2015 for adults ≥18 years (N = 18,088). We identified three risk profiles. The highest surgical delay profile (11% of the sample) with a 30% likelihood of delaying surgery >90 days were young Black men, <55 years old, living in a non-Appalachian county, and single/never married, with a high probability of having private health insurance. The medium surgical delay profile (46% of the sample) with a 21% likelihood of delay were 55–69 years old, White, married, and having private health insurance. The lowest surgical delay profile (42% of the sample) with a 14% likelihood of delay were ≥70 years with public health insurance as well as had a high probability of being White and married. We identified that even with health insurance coverage, Blacks living in non-Appalachian counties had the highest surgical delay, which was almost double that of Whites in the lowest delay profile. These disparities in PCa surgical delay may explain differences in health outcomes in Blacks who are most at-risk.