Place of Residence Effect on Likelihood of Surviving Prostate Cancer

Purpose To examine geographic variation in survival time of men diagnosed with prostate cancer, adjusted for patient and disease characteristics. Method Survival times for a geographically referenced database of 27,189 incident prostate cancer cases (ICD-O-2: C61.9) from Connecticut, 1984–1998, were evaluated using a newly developed extension of the spatial scan statistic for survival data. Results Statewide, median survival time was 4.6 years following diagnosis. Age-adjusted survival times across most locales around Connecticut did not differ markedly from the statewide pattern, but our analysis revealed 3 zones with noteworthy differences. Analysis of survival times adjusted for age as well as tumor grade and stage produced only two locations with significant results, and further adjustment for racial composition of cases yielded only one location with significant distinct (lower) survival times. Among cases within that place, the likelihood of dying was estimated to be 1.39-times greater than that of cases different from those diagnosed elsewhere around the state (p = 0.009). Conclusion The prognosis for men with prostate cancer may differ, in part, by virtue of where they live when diagnosed. Measuring geographic differences in survival time should facilitate the targeting of clinical and ancillary services to persons at high risk of poor outcomes.