title: Clarifying the positive association between education and prostate cancer: a Monte Carlo simulation approach.
abstract: Using the 1993-2011 data from the Wisconsin Longitudinal Study (N = 5,218), we examine prostate cancer screening, mortality after the diagnosis, and health behaviors as potential mechanisms explaining the paradoxical association between men's higher education and higher prostate cancer risk. Our study combines within-cohort longitudinal hazard models predicting a prostate cancer diagnosis with Monte Carlo simulations estimating the joint effects of socioeconomic differences in prostate cancer screening and mortality after the diagnosis. Our findings strongly suggest that higher utilization of prostate cancer screening and lower mortality after the diagnosis are important explanations for higher prostate rates among more educated men. In addition to applying an innovative method to the issues of prostate cancer incidence and survival, our results have potentially important implications for the current debate about the utility of prostate cancer screening as well as for accurate predictions of future mortality and morbidity trends in the expanding older population.
authors.affiliation: Department of Sociology & Criminology, Law, and Justice, Population Research Institute, Pennsylvania State University, University Park, PA, USA tup3@psu.edu.
authors.forename: Tetyana
authors.initials: T
authors.lastname: Pudrovska
authors.affiliation: The Huck Institutes of Life Sciences, Pennsylvania State University, State College, PA, USA.
authors.forename: Andriy
authors.initials: A
authors.lastname: Anishkin
mesh_terms: D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D004522:Educational Status; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D012307:Risk Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014922:Wisconsin / Q000453:epidemiology
keywords: cancer; education; life course