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Defining aggressive prostate cancer: a geospatial perspective.

Daniel Wiese1,2, Tesla D DuBois3, Kristen A Sorice3

  • 1Department of Surveillance and Health Equity Science, American Cancer Society, 3380 Chastain Meadows Pkwy NW Suite 200, Kennesaw, GA, 30144, USA. daniel.wiese@cancer.org.

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|August 14, 2023
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Summary
This summary is machine-generated.

Different definitions for aggressive prostate cancer (PCan) impact spatial analysis for intervention. Using distant SEER summary stage (D2) aligns best with PCan mortality patterns, offering a consistent approach for targeted public health efforts.

Keywords:
Aggressive prostate cancerGeospatialProstate cancerSurvival analysis

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Area of Science:

  • Oncology
  • Geospatial Analysis
  • Public Health

Background:

  • Spatial analysis aids in identifying at-risk communities for aggressive prostate cancer (PCan) requiring intervention.
  • Multiple definitions exist for aggressive PCan, complicating targeted public health efforts.
  • This study evaluates three aggressive PCan definitions and their geospatial patterns relative to PCan-specific mortality.

Purpose of the Study:

  • To assess how different definitions of aggressive prostate cancer influence spatial patterns and intervention targets.
  • To compare geospatial patterns derived from three distinct aggressive PCan definitions against PCan-specific mortality data.
  • To provide methodologic insights for selecting appropriate aggressive PCan definitions in geospatial studies.

Main Methods:

  • Utilized Pennsylvania State Cancer Registry data (2005-2015).
  • Applied three definitions for aggressive PCan: D1 (T4/N1/M1 or Gleason ≥8), D2 (distant SEER summary stage), and D3 (Gleason ≥7).
  • Employed Bayesian spatial models and Cox regression to identify and compare geographic clusters of aggressive PCan and PCan-specific mortality.

Main Results:

  • The number, location, and size of aggressive PCan clusters varied significantly by definition.
  • Spatial patterns showed overlap across all definitions, but D2 (distant SEER summary stage) clusters most closely mirrored PCan-specific mortality clusters.
  • The D2 definition yielded fewer intervention clusters and was less sensitive to missing data compared to TNM-staging-based definitions.

Conclusions:

  • The distant SEER summary stage definition (D2) for aggressive prostate cancer demonstrated the strongest alignment with PCan-specific mortality patterns.
  • Adopting D2 in future geospatial research can enhance consistency and enable standardized comparisons across studies.
  • This definition offers a more robust and less data-sensitive approach for identifying high-risk populations for prostate cancer intervention.