Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden

Prostate Cancer Prostatic Dis. 2012 Jun;15(2):128-34. doi: 10.1038/pcan.2011.46. Epub 2011 Oct 11.


Background: The objective was to analyze the association between neighborhood deprivation and prostate cancer mortality, after adjusting for individual characteristics.

Methods: This study was designed as a follow-up study of prostate cancer mortality between 1 January 1990 and 31 December 2008 in patients aged 25-74 years (a total of 73 159 patients). Multilevel logistic regression analyses were performed with individual-level characteristics at the first level and level of neighborhood deprivation at the second level.

Results: The age-standardized prostate cancer mortality rate was 1.5 times higher in men living in high-deprivation neighborhoods than in those living in the most affluent neighborhoods. Mortality rates were also associated with certain individual-level characteristics, that is, age, marital status, family income, educational attainment, immigration status, urban/rural status, mobility and comorbidity. For example, there was a strong relationship between prostate cancer mortality and being unmarried, having a low income or educational attainment, and hospitalization for chronic obstructive pulmonary disease. In the full model, the risk of prostate cancer mortality was 25% higher in men living in the most deprived neighborhoods than in those living in the most affluent neighborhoods.

Conclusions: High level of neighborhood deprivation independently predicts prostate cancer mortality. This raises important clinical and public health concerns. Both individual- and neighborhood-level approaches are important in healthcare policies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Educational Status
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prostatic Neoplasms / mortality*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Registries
  • Residence Characteristics*
  • Socioeconomic Factors
  • Sweden / epidemiology
  • Unemployment