The Relative Importance of Race Compared to Health Care and Social Factors in Predicting Prostate Cancer Mortality: A Random Forest Approach

Heidi A. Hanson , University of Utah
Claire Leiser, Huntsman Cancer Institute, University of Utah
Christopher Martin, University of Utah
Brock O'Neil, University of Utah
William Lowrance, University of Utah
Ken R. Smith, University of Utah

African-American men have increased risks for prostate cancer (PCa) mortality rooted in both biological and socio-environmental mechanisms. However, with personalized medicine, focus has increasingly shifted to underlying genetic differences. Using the Surveillance, Epidemiology, and End Results (SEER) Database, we identified 514,878 men with PCa diagnosed between 2004-2012. Applying random forest methods with variable importance measures, we analyzed four categories of factors (tumor characteristics, race, healthcare, and social) and their relative importance for PCa specific mortality. Although race had a significant impact in many age groups and disease stages, healthcare and social factors, known to also be associated with racial disparities, had greater or similarly important effects across all ages and stages. Eradicating disparities in prostate cancer survival will take a multi-pronged approach including advances in precision medicine. However, disparities will persist unless healthcare access and social equality is achieved among all populations.

See paper

 Presented in Session 11. Health & Mortality 2