title: Impact of Age, Race and Socio-economic Status on Temporal Trends in Late-Stage Prostate Cancer Diagnosis in Florida.
abstract: Individual-level data from the Florida Cancer Data System (1981-2007) were analysed to explore temporal trends of prostate cancer late-stage diagnosis, and how they vary based on race, income and age. Annual census-tract rates were computed for two races (white and black) and two age categories (40-65, >65) before being aggregated according to census tract median household incomes. Joinpoint regression and a new disparity statistic were applied to model temporal trends and detect potential racial and socio-economic differences. Multi-dimensional scaling was used as an innovative way to visualize similarities among temporal trends in a 2-D space. Analysis of time-series indicated that late-stage diagnosis was generally more prevalent among blacks, for age category 40-64 compared to older patients covered by Medicare, and among classes of lower socio-economic status. Joinpoint regression also showed that the rate of decline in late-stage diagnosis was similar among older patients. For younger patients, the decline occurred at a faster pace for blacks with rates becoming similar to whites in the late 90s, in particular for higher incomes. Both races displayed distinct spatial patterns with higher rates of late-stage diagnosis in the Florida Panhandle for whites whereas high rates clustered in South-eastern Florida for blacks.
authors.affiliation: BioMedware, Inc., Ann Arbor, MI, USA.
authors.forename: Pierre
authors.initials: P
authors.lastname: Goovaerts
authors.affiliation: University of Florida, Gainesville, FL, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Xiao
authors.affiliation: Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Clement K
authors.initials: CK
authors.lastname: Gwede
authors.affiliation: Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
authors.forename: Fei
authors.initials: F
authors.lastname: Tan
authors.affiliation: Florida Department of Health, Tallahassee, FL, USA.
authors.forename: Youjie
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
authors.forename: Georges
authors.initials: G
authors.lastname: Adunlin
authors.affiliation: Florida A&M University, Tallahassee, FL, USA.
authors.forename: Askal
authors.initials: A
authors.lastname: Ali
keywords: PSA screening; census tracts; disparities; joinpoint regression; socio-economic status