Abstract A093: Race, neighborhood economic segregation, and prostate cancer risk in southeastern Pennsylvania

Abstract Prostate cancer is the second most diagnosed cancer in men, with persistent racial and socioeconomic disparities in incidence and outcomes. Black men are disproportionately affected, experiencing higher rates of diagnosis and mortality than White men. This study examines geographic variation in prostate cancer incidence and whether risk varies by race and neighborhood-level economic segregation. We analyzed population-based data from the Pennsylvania Cancer Registry on 24,702 prostate cancer cases diagnosed from 2011 to 2021 across five counties in Southeast Pennsylvania. Incidence rates were examined overall and by stage (early and late). Associations between tract-level prostate cancer risk, racial composition, and economic segregation were evaluated using Poisson regression. Economic segregation was measured using quartiles of the income-based neighborhood Index of Concentration at the Extremes (nICE-income). Geographic variability in risk was assessed using Bayesian geo-additive models. The association between neighborhood economic segregation (nICE-income) and prostate cancer risk varied notably by race. Among White men, incidence was highest in the most economically privileged neighborhoods. White men in the least privileged neighborhoods had significantly lower overall risk (RR: 0.67, 95% CI: 0.61–0.74), and lower early-stage (RR: 0.63, 95% CI: 0.56–0.71) and late-stage (RR: 0.77, 95% CI: 0.63–0.96) disease incidence. In contrast, Black men in the least privileged neighborhoods had the highest incidence. Compared to those in the most privileged areas, they had elevated overall risk (RR: 1.18, 95% CI: 1.02–1.39), driven largely by late-stage disease (RR: 1.43, 95% CI: 1.15–1.96); early-stage cancer showed no significant difference in risk between the least privileged and most privileged areas (RR: 1.07, 95% CI: 0.86–1.33). These opposing patterns may reflect differences in healthcare access, screening, or other social determinants. Geographic relative risk (gRR) estimates highlighted racial differences in tract-level prostate cancer risk. Among White men, gRR ranged from 0.51–1.62 (overall), 0.51–1.46 (early-stage), and 0.74–1.46 (late-stage), with statistically significant high-risk clusters in northeastern Montgomery and Bucks counties. Among Black men, gRR ranged from 0.46–1.77 (overall), 0.51–1.96 (early-stage), and 0.68–1.50 (late-stage), with statistically significant high-risk clusters in Philadelphia county. Adjustment for nICE-income attenuated late-stage clustering among Black men, suggesting a stronger mediating effect of economic segregation. These findings highlight how race and neighborhood economic conditions shape prostate cancer risk. Divergent nICE-income gradients suggest that structural socioeconomic factors impact Black and White communities differently. Results underscore the need for targeted, equity-focused cancer prevention and control strategies. Citation Format: Michelle Botyrius, Ann Klassen, PhD, Charnita Zeigler-Johnson, PhD, MPH, Jenna Kantor, MS, Scott Keith, PhD, Daniel Wiese, PhD, Kevin A. Henry, PhD. Race, neighborhood economic segregation, and prostate cancer risk in southeastern Pennsylvania [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A093.