Socioeconomic status, urbanization grade, and prostate cancer

In a population-based case-referent study, carried out in The Netherlands, the relationship between socioeconomic status (SES) and urbanization grade on the one hand and prostate cancer incidence on the other has been investigated. Two explanations for a potential association have been taken into account. First, there is a relationship with SES class (or with urbanization grade) in the past, referring to an effect on the induction or promotion of prostate cancer caused by variation in exposure to particular risk factors. Second, there is a relationship with current SES (or urbanization grade), resulted in differences in medical screening. Study data were obtained by means of a validated mailed questionnaire, which has been completed and returned by 345 cases (with histologically confirmed prostate cancer) and 1,346 referents (patients with benign prostate hyperplasia). The response was 79%. No clear relationship was observed with SES, based on the major job held between 1960-1970 (the period of cancer induction), nor was this the case with SES based on the longest-held job (as a proxy for current SES). A slight, but statistically nonsignificant, trend was found of higher risks in subjects living in rural areas, with an urban/rural ratio of 0.79. Considering the results of this study and those of previous studies reviewed in this paper, it might be doubted that any relationship is to be found between prostate cancer risk and SES or urbanization grade.