Salud publica de Mexico · 2026
Educational disparities in prostate cancer survival: a retrospective cohort study from Mexico City.
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Hernández-Pérez Jesús Gibran, Reyes-Morales Hortensia, Valenzuela-Sánchez Abraham, Lajous Martin, Rodríguez-Covarrubias Francisco, Espin-Arellano Lucino Iván, Morales-Carmona Evangelina, Manzanilla-García Hugo, Torres-Sánchez Luisa Elvira
Аннотация
OBJECTIVE: To evaluate the relationship between educational level and prostate cancer (PC) survival and explore the role of histological differentiation and reasons for PC testing on this association.
MATERIALS AND METHODS: A retrospective cohort was constructed by linking data from men diagnosed with PC between 2011 and 2014 in two secondary care and four tertiary-care hospitals in Mexico City with the National Death Registry, with follow-up through December 2021. Educational level, reasons for testing (symptomatic vs preventive), and histological differentiation were obtained through structured questionnaires. Overall survival (OS) and PC-specific survival (PCSS) at five and eight years were estimated using Kaplan-Meier curves, and PC mortality was evaluated using Cox proportional hazards models.
RESULTS: During a median follow-up of 8.34 years, OS was 81%, and PCSS was 85%. Lower educational level was associated with higher PC mortality (adjusted HR 2.30; 95%CI: 1.16,4.54). The highest mortality was observed among men with low education and poorly differentiated tumors or among those who underwent screening due to the presence of prostate symptoms.
CONCLUSIONS: Educational level was the strongest predictor of PC survival, underscoring the importance of targeted health education to improve preventive care, informed decision-making, and treatment adherence.
MATERIALS AND METHODS: A retrospective cohort was constructed by linking data from men diagnosed with PC between 2011 and 2014 in two secondary care and four tertiary-care hospitals in Mexico City with the National Death Registry, with follow-up through December 2021. Educational level, reasons for testing (symptomatic vs preventive), and histological differentiation were obtained through structured questionnaires. Overall survival (OS) and PC-specific survival (PCSS) at five and eight years were estimated using Kaplan-Meier curves, and PC mortality was evaluated using Cox proportional hazards models.
RESULTS: During a median follow-up of 8.34 years, OS was 81%, and PCSS was 85%. Lower educational level was associated with higher PC mortality (adjusted HR 2.30; 95%CI: 1.16,4.54). The highest mortality was observed among men with low education and poorly differentiated tumors or among those who underwent screening due to the presence of prostate symptoms.
CONCLUSIONS: Educational level was the strongest predictor of PC survival, underscoring the importance of targeted health education to improve preventive care, informed decision-making, and treatment adherence.