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Neighbourhood social deprivation and risk of prostate cancer



Striking geographic variations in prostate cancer incidence suggest an aetiological role for spatially-distributed factors. We assessed whether neighbourhood social deprivation, which can reflect limited social contacts, unfavourable lifestyle and environmental exposures, is associated with prostate cancer risk.


In 2005–2012, we recruited 1931 incident prostate cancer cases and 1994 controls in a case–control study in Montreal, Canada. Lifetime residential addresses were linked to an area-based social deprivation index around recruitment (2006) and about 10 years earlier (1996). Logistic regression estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs).


Men residing in areas characterised by greater social deprivation had elevated prostate cancer risks (ORs of 1.54 and 1.60 for recent and past exposures, respectively; highest vs lowest quintiles), independently from area- and individual-level confounders and screening patterns. The increase in risk with recent high social deprivation was particularly elevated for high-grade prostate cancer at diagnosis (OR 1.87, 95% CI 1.32–2.64). Associations were more pronounced for neighbourhoods with higher proportions of separated/divorced or widowed individuals in the past, and with higher percentages of residents living alone recently.


These novel findings, suggesting that neighbourhood-level social deprivation increases the risk of prostate cancer, point out to potential targeted public health interventions.

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Fig. 1: Collection and geocoding of residential addresses.

Data availability

The data that support the findings of this study are available on reasonable request from the corresponding author, in keeping with ethics regulations. The data are not publicly available for confidentiality reasons.

Code availability

Code is available from the authors upon request.


  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49.

    Article  PubMed  Google Scholar 

  2. Société canadienne du cancer. Comité consultatif des statistiques canadiennes sur le cancer. Statistiques canadiennes sur le cancer 2021. Toronto (Ontario): Société canadienne du cancer; 2021.

  3. Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D. Cancer epidemiology and prevention, fourth edition. Oxford: Oxford University Press; 2017.

  4. Conti DV, Darst BF, Moss LC, Saunders EJ, Sheng X, Chou A, et al. Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction. Nat Genet. 2021;53:65–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Klassen AC, Platz EA. What can geography tell us about prostate cancer? Am J Prev Med. 2006;30:S7–15.

    Article  PubMed  Google Scholar 

  6. Lee J, Demissie K, Lu SE, Rhoads GG. Cancer incidence among Korean-American immigrants in the United States and native Koreans in South Korea. Cancer Control. 2007;14:78–85.

    Article  PubMed  Google Scholar 

  7. Shimizu H, Ross RK, Bernstein L, Yatani R, Henderson BE, Mack TM. Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles County. Br J Cancer. 1991;63:963–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Townsend P. Deprivation. J Soc Policy. 1987;16:125–46.

    Article  Google Scholar 

  9. Madathil S, Blaser C, Nicolau B, Richard H, Parent ME. Disadvantageous socioeconomic position at specific life periods may contribute to prostate cancer risk and aggressiveness. Front Oncol. 2018;8:515.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nicolau B, Arekunnath Madathil S, Castonguay G, Rousseau MC, Parent ME, Siemiatycki J. Shared social mechanisms underlying the risk of nine cancers: a life course study. Int J Cancer. 2018;144:59–67.

  11. Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, et al. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control. 2009;20:417–35.

    Article  PubMed  Google Scholar 

  12. Marså K, Johnsen NF, Bidstrup PE, Johannesen-Henry CT, Friis S. Social inequality and incidence of and survival from male genital cancer in a population-based study in Denmark, 1994-2003. Eur J Cancer. 2008;44:2018–29.

    Article  PubMed  Google Scholar 

  13. Nilsen TIL, Johnsen R, Vatten LJ. Socio-economic and lifestyle factors associated with the risk of prostate cancer. Br J Cancer. 2000;82:1358–63.

    Article  PubMed Central  Google Scholar 

  14. Steenland K, Rodriguez C, Mondul A, Calle EE, Thun M. Prostate cancer incidence and survival in relation to education (United States). Cancer Causes Control. 2004;15:939–45.

    Article  PubMed  Google Scholar 

  15. Mihor A, Tomsic S, Zagar T, Lokar K, Zadnik V. Socioeconomic inequalities in cancer incidence in Europe: a comprehensive review of population-based epidemiological studies. Radio Oncol. 2020;54:1–13.

    Article  Google Scholar 

  16. DeRouen MC, Schupp CW, Yang J, Koo J, Hertz A, Shariff-Marco S, et al. Impact of individual and neighborhood factors on socioeconomic disparities in localized and advanced prostate cancer risk. Cancer Causes Control. 2018;29:951–66.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Eylert MF, Bahl A, Hounsome L, Verne J, Jefferies ER, Persad RA. The impact of socio-economic deprivation on incidence, treatment and mortality from prostate cancer in England, 1990–2010. J Clin Urol. 2015;9:93–101.

    Article  Google Scholar 

  18. Rundle A, Neckerman KM, Sheehan D, Jankowski M, Kryvenko ON, Tang D, et al. A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer. Cancer Causes Control. 2013;24:297–303.

    Article  PubMed  Google Scholar 

  19. Salmon C, Song L, Muir K, Pashayan N, Dunning AM, Batra J, et al. Marital status and prostate cancer incidence: a pooled analysis of 12 case-control studies from the PRACTICAL consortium. Eur J Epidemiol. 2021;36:913–25.

    Article  PubMed  Google Scholar 

  20. Coughlin SS. A review of social determinants of prostate cancer risk, stage, and survival. Prostate Int. 2020;8:49–54.

    Article  PubMed  Google Scholar 

  21. Wu Z, Nguyen NH, Wang D, Lynch BM, Hodge AM, Bassett JK, et al. Social connectedness and mortality after prostate cancer diagnosis: a prospective cohort study. Int J Cancer. 2019;147:766–76.

  22. Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. J Health Soc Behav. 2010;51:S54–66.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tangen CM, Goodman PJ, Till C, Schenk JM, Lucia MS, Thompson IM Jr. Biases in recommendations for and acceptance of prostate biopsy significantly affect assessment of prostate cancer risk factors: results from two large randomized clinical trials. J Clin Oncol. 2016;34:4338–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Parent ME, Goldberg MS, Crouse DL, Ross NA, Chen H, Valois MF, et al. Traffic-related air pollution and prostate cancer risk: a case-control study in Montreal, Canada. Occup Environ Med. 2013;70:511–8.

    Article  PubMed  Google Scholar 

  25. Blanc-Lapierre A, Spence A, Karakiewicz PI, Aprikian A, Saad F, Parent M. Metabolic syndrome and prostate cancer risk in a population-based case-control study in Montreal, Canada. BMC public health. 2015;15:913.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Environmental Systems Research Institute Inc. (ESRI). ArcGIS Desktop 9.3.1. Redlands: ESRI Inc.; 2009.

  27. Pampalon R, Hamel D, Gamache P, Raymond G. A deprivation index for health planning in Canada. Chronic Dis Can. 2009;29:178–91.

    Article  CAS  PubMed  Google Scholar 

  28. Pampalon R, Hamel D, Gamache P, Simpson A, Philibert M. Validation of a deprivation index for public health: a complex exercise illustrated by the Quebec index. Chronic Dis Inj Can. 2014;34:12–22.

    Article  CAS  PubMed  Google Scholar 

  29. Salinas CA, Tsodikov A, Ishak-Howard M, Cooney KA. Prostate cancer in young men: an important clinical entity. Nat Rev Urol. 2014;11:317–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Wright JL, Salinas CA, Lin DW, Kolb S, Koopmeiners J, Feng Z, et al. Prostate cancer specific mortality and Gleason 7 disease differences in prostate cancer outcomes between cases with Gleason 4 + 3 and Gleason 3 + 4 tumors in a population based cohort. J Urol. 2009;182:2702–7.

    Article  PubMed  PubMed Central  Google Scholar 

  31. White IR, Royston P, Wood AM. Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011;30:377–99.

    Article  PubMed  Google Scholar 

  32. VanderWeele TJ, Ding P. Sensitivity analysis in observational research: introducing the E-value. Ann Intern Med. 2017;167:268–74.

    Article  PubMed  Google Scholar 

  33. Hurwitz LM, Agalliu I, Albanes D, Barry KH, Berndt SI, Cai Q, et al. Recommended definitions of aggressive prostate cancer for etiologic epidemiologic research. J Natl Cancer Inst. 2021;113:727–34.

    Article  PubMed  Google Scholar 

  34. Shafique K, Oliphant R, Morrison DS. The impact of socio-economic circumstances on overall and grade-specific prostate cancer incidence: a population-based study. Br J Cancer. 2012;107:575–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Klassen AC, Curriero FC, Hong JH, Williams C, Kulldorff M, Meissner HI, et al. The role of area-level influences on prostate cancer grade and stage at diagnosis. Prev Med. 2004;39:441–8.

    Article  PubMed  Google Scholar 

  36. Seo HS, Lee NK. Predictors of PSA screening among men over 40 years of age who had ever heard about PSA. Korean J Urol. 2010;51:391–7.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Fone DL, Farewell DM, White J, Lyons RA, Dunstan FD. Socioeconomic patterning of excess alcohol consumption and binge drinking: a cross-sectional study of multilevel associations with neighbourhood deprivation. BMJ Open. 2013;3:e002337.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lakshman R, McConville A, How S, Flowers J, Wareham N, Cosford P. Association between area-level socioeconomic deprivation and a cluster of behavioural risk factors: cross-sectional, population-based study. J Public Health. 2011;33:234–45.

    Article  Google Scholar 

  39. Xiao Q, Keadle SK, Berrigan D, Matthews CE. A prospective investigation of neighborhood socioeconomic deprivation and physical activity and sedentary behavior in older adults. Prev Med. 2018;111:14–20.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Curtis S, Setia MS, Quesnel-Vallee A. Socio-geographic mobility and health status: a longitudinal analysis using the National Population Health Survey of Canada. Soc Sci Med 2009;69:1845–53.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Hamano T, Li X, Sundquist J, Sundquist K. Neighborhood social capital and incidence and mortality of prostate cancer: a Swedish cohort study. Aging Clin Exp Res. 2021;33:3333–42.

    Article  PubMed  Google Scholar 

  42. Lynch SM, Mitra N, Ross M, Newcomb C, Dailey K, Jackson T, et al. A Neighborhood-Wide Association Study (NWAS): example of prostate cancer aggressiveness. PLoS ONE. 2017;12:e0174548.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Macintyre S, Ellaway A. Neighborhoods and health: an overview. Neighborhoods Health. 2003;20:42.

    Google Scholar 

  44. VanderWeele DJ, Brown CD, Taxy JB, Gillard M, Hatcher DM, Tom WR, et al. Low-grade prostate cancer diverges early from high grade and metastatic disease. Cancer Sci. 2014;105:1079–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Penney KL, Stampfer MJ, Jahn JL, Sinnott JA, Flavin R, Rider JR, et al. Gleason grade progression is uncommon. Cancer Res. 2013;73:5163–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. World Cancer Research Fund International, American Institute to Cancer Research. Diet, nutrition, physical activity and prostate cancer. 2014.

  47. Gilham K, Gu Q, Dummer TJB, Spinelli JJ, Murphy RA. Diet quality and neighborhood environment in the Atlantic Partnership for Tomorrow’s Health Project. Nutrients. 2020;12:3217.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Ngamini Ngui A, Apparicio P, Philibert M, Fleury M-J. Neighborhood characteristics associated with the availability of alcohol outlets in quebec, Canada. J Addict. 2015;2015:876582-.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Crouse DL, Ross NA, Goldberg MS. Double burden of deprivation and high concentrations of ambient air pollution at the neighbourhood scale in Montreal, Canada. Soc Sci Med. 2009;69:971–81.

    Article  PubMed  Google Scholar 

  50. Pinault L, Crouse D, Jerrett M, Brauer M, Tjepkema M. Spatial associations between socioeconomic groups and NO2 air pollution exposure within three large Canadian cities. Environ Res. 2016;147:373–82.

    Article  CAS  PubMed  Google Scholar 

  51. Short H, Al Sayah F, Ohinmaa A, Lahtinen M, Johnson JA. The relationship of neighbourhood-level material and social deprivation with health-related quality of life. Qual Life Res. 2018;27:3265–74.

    Article  PubMed  Google Scholar 

  52. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338:171–9.

    Article  CAS  PubMed  Google Scholar 

  53. Reiche EM, Nunes SO, Morimoto HK. Stress, depression, the immune system, and cancer. Lancet Oncol. 2004;5:617–25.

    Article  CAS  PubMed  Google Scholar 

  54. Keyes KM, Hatzenbuehler ML, Grant BF, Hasin DS. Stress and alcohol: epidemiologic evidence. Alcohol Res Curr Rev. 2012;34:391–400.

    CAS  Google Scholar 

  55. Zellner DA, Loaiza S, Gonzalez Z, Pita J, Morales J, Pecora D, et al. Food selection changes under stress. Physiol Behav. 2006;87:789–93.

    Article  CAS  PubMed  Google Scholar 

  56. Gamache P, Hamel D, Blaser C. Material and social deprivation index: a summary. 2019.

  57. Krieger N, Williams DR, Moss NE. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997;18:341–78.

    Article  CAS  PubMed  Google Scholar 

  58. Leech JA, Nelson WC, Burnett RT, Aaron S, Raizenne ME. It’s about time: a comparison of Canadian and American time–activity patterns. J Expo Sci Environ Epidemiol. 2002;12:427–32.

    Article  Google Scholar 

  59. Garcia-Closas M, Berrington, de Gonzalez A. Invited commentary: Screening and the elusive etiology of prostate cancer. Am J Epidemiol. 2015;182:390–3.

    Article  PubMed  PubMed Central  Google Scholar 

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The authors would like to thank all members of the Epidemiology and Biostatistics Unit at INRS-Centre Armand-Frappier Santé Biotechnologie who were involved in the conduct of the study. In particular, we want to highlight the contribution of Hughes Richard in the preparation of the databases. We also thank the urologists from the participating hospitals for their collaboration in patients’ access.


This work was supported financially by the Canadian Institutes of Health Research (grant CCP-155423) and the Canadian Cancer Society (grant 705562). CS held doctoral training awards from the Fonds de recherche du Québec – Santé.

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CS conducted the analysis, interpreted the results and prepared the manuscript. M-EP supervised the work, designed and conducted the PROtEuS study and reviewed the manuscript. All authors participated in the interpretation of data and have read and approved the final version of the manuscript.

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Correspondence to Marie-Élise Parent.

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Salmon, C., Quesnel-Vallée, A., Barnett, T.A. et al. Neighbourhood social deprivation and risk of prostate cancer. Br J Cancer (2023).

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