Prostate Cancer Coverage from Every Angle

Environmental Quality and Stage of Prostate Cancer at Diagnosis

By: Susan Reckling
Posted: Tuesday, July 6, 2021

To assess the potential association between environmental quality and advanced stage of prostate cancer at diagnosis, Michael R. Abern, MD, of the University of Illinois at Chicago, and colleagues paired data from the environmental quality index (EQI) and the Surveillance, Epidemiology, and End Results (SEER) program. The investigators discovered that lower environmental quality was associated with an advanced stage of prostate cancer at diagnosis. Their study findings were published in Prostate Cancer and Prostate Diseases.

“When we drilled down further into the subdomains of the EQI, we found that some of the associations were stronger than others,” commented Dr. Abern in an institutional press release. “Specifically, the land, water, and sociodemographic domains seem to be driving the association more than air or built domains.”

Included in the study cohort were 252,164 cases of prostate cancer from the SEER program from 2010 to 2014. Most cases (92%) were localized at diagnosis. EQI—a county-level metric for 2000 to 2005—combined data from 18 sources and reports on overall ambient EQI as well as 5 environmental quality subdomains (air, water, land, built, and sociodemographic). According to the study investigators, the higher EQI values represented lower environmental quality.

In the adjusted regression models, overall environmental quality EQI (odds ratio [OR] = 1.20), water EQI (OR = 1.34), land EQI (OR = 1.35), and sociodemographic EQI (OR = 1.29) were associated with metastatic prostate cancer at diagnosis. In addition, the investigators reported a dose response increase in the odds ratio from the lowest to the highest EQI quintiles in these domains. In addition, based on self-reported information on race, the Black race was an independent predictor of metastatic prostate cancer at diagnosis (OR = 1.36) and in stratified analysis by race. Finally, the investigators observed a stronger association between overall EQI and metastatic prostate cancer in Black men (OR = 1.53) than White men (OR = 1.18).

Disclosure: For disclosures of the study authors, visit

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