Socioeconomic position as a social determinant of health and its effect on cardiovascular outcomes and mortality in patients with prostate cancer: A SEER-Medicare based study.

• DOI: 10.1200/jco.2025.43.5_suppl.315
• Publication Date: 2025-02-18T14:35:11Z
• Authors: Tarek Nahle; Omar M Makram Els...; Viraj R Shah; Harikrishnan Hyma...; Sami Abi Farraj; Priyanshu Nain; Nickolas Stabellini; Sadeer Al-Kindi; Umang Swami; Jordan Alana Ciuro; Jigarkumar R. Parikh; Ashanda R Esdaille; Zachary Klaassen; Martha K Terris; Jennifer Cullen; Neal L Weintraub; Neeraj Agarwal; Avirup Guha

315 Background: Socioeconomic position (SEP) is a key social determinant of health (SDOH) associated with disparities in cancer care and cardiovascular (CV) outcomes patients prostate (PC). Understanding the impact SEP on critical for addressing inequities PC CV outcomes. Methods: We conducted retrospective cohort study SEER-Medicare database. Multiple were assessed ≥65 years age no prior disease localized or advanced PC. was defined using census-tract level Yost index where those living first second quintiles considered as low areas. A competing risk analysis univariable multivariable Fine-Gray Models used events (CVE), mortality (CVm) specific (PCsm). CVEs included myocardial infarction, heart failure, atrial fibrillation, ischemic stroke, peripheral artery disease. All-cause Cox proportional hazard (PH) models. All models adjusted age, race, marital status, education level, grade, TNM stage, diabetes, hypertension, hyperlipidemia, chronic kidney disease, receiving chemotherapy. sub-group further who self-identified non-Hispanic Black (NHB). Results: 150,647 whom 102,271 had high 48,376 SEP. Patients have shown higher risks CVm (subdistribution ratio [sHR] 1.25, 95% CI 1.19-1.32, p<0.001), PCsm (sHR: 1.20, 1.14-1.26, CVE (sHR 1.07, 1.04-1.09, all-cause (adjusted HR 1.17, 1.14-1.20, p<0.001) when compared to Similarly, NHB subgroup analysis, showed an increase 11% CVE, 37% CVm, 21% 20% (Table). Conclusions: Adverse SEP, proxy SDOH, plays important role metastatic by increasing adverse survival up 25% overall population individuals. Survival (competing models) PH regression various fully model. Overall (n=150,647) (n=15,474) (Competing = mortality)sHR (95% CI, p-value) 1.07 (1.04-1.09, 1.11 (1.03-1.20, p=0.007) except CVD 1.25 (1.19-1.32, 1.37 (1.15-1.64, PCsm)sHR 1.20 (1.14-1.26, 1.21 (1.04-1.41, p=0.016) (Cox)aHR 1.17 (1.14-1.20, (1.08-1.35, p=0.001)