Abstract 3588: Modifiable factors associated with survival among a racially diverse and low-income population with prostate cancer

Background: Prostate cancer is the most diagnosed cancer among men in the United States and is the second leading cause of cancer-related deaths. Black men have the highest incidence and mortality rates compared to all other racial or ethnic groups and these disparities are not fully understood. Objective: In this study, we aim to investigate various sociodemographic, lifestyle, health and dietary factors that might be associated with survival in men diagnosed with prostate cancer within a study designed to evaluate cancer health disparities. Methods: The Southern Community Cohort Study is a prospective cohort study of 34,313 adult men recruited between 2002 and 2009, with a focus on Black individuals and those with low socioeconomic status. At recruitment, a baseline questionnaire was administered to assess sociodemographic and lifestyle factors. Participants were followed over time by linkages to state cancer registries for cancer diagnosis and the National Death Index for death. Chi-squared and ANOVA tests examined associations between baseline characteristics and racial group. Cox proportional hazards regression models were used to assess relationships between covariates and survival, calculating hazard ratios for overall survival with 95% confidence intervals. Results: Our study included 1,367 men with prostate cancer of whom 350 died, including 291 Black and 59 White men. Only current cigarette smoking was associated with increased risk of mortality among both Black (HR= 2.22, 95% CI=1.57-3.14) and White (HR= 4.09, 95% CI=1.56-10.75) men in comparison to never-smokers and only higher intake of added sugars was associated with reduced risk among both Black (HR=0.66, 95% CI=0.46-0.96) and White men (HR=0.31, 95% CI: 0.13-0.89). Among Black men only, diabetes history (HR=1.58, 95% CI=1.17-2.14) was associated with an increased risk of mortality and hypercholesterolemia (HR=0.74, 95% CI=0.55-0.99) was associated with decreased risk. Among White men only, living in an area of highest deprivation (HR=3.12, 95% CI=1.18-8.27) and consuming higher quantities of red meat (HR=3.66, 95% CI=1.37-9.73) were associated with increased risk of death and higher intake of whole grains (HR=0.34, 95% CI=0.15-0.76) was associated with a decreased risk. Conclusion: Our study identified an increased risk of mortality in men with prostate cancer associated with several modifiable lifestyle, health and dietary factors. Although not all these factors were associated with increased risk among both Black and White men, differing lifestyle behaviors based on race highlight the need for studies to better understand mortality risk. However, cigarette smoking was strongly associated with risk for all groups, thus, tobacco cessation should be considered for men with prostate cancer. These findings highlight the need for targeted interventions to address disparities in outcomes in men with prostate cancer. Citation Format: Sobia T. Siddiqui, Martha J. Shrubsole, Heather Munro, Xijing Han, Francesca Kolitsopoulos, Julia S. Perkins, Leo J. Russo, Loren Lipworth, Wei Zheng. Modifiable factors associated with survival among a racially diverse and low-income population with prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3588.