{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T12:28:55Z","timestamp":1786796935531,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Penile cancer is a rare malignancy influenced by socioeconomic factors. The Area Deprivation Index (ADI) is a validated measure of neighborhood\u2010level socioeconomic disadvantage, and its association with penile cancer stage at presentation has not been studied. This study aimed to assess the relationship between the ADI and advanced\u2010stage disease at diagnosis in penile cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted with the Michigan Department of Health and Human Services database of patients aged \u226518 years with penile squamous cell carcinoma from 2004 to 2019. Advanced\u2010stage disease was defined as pathological T stage \u22652, pathological evidence of nodal metastasis, or reported presence of distal metastasis. ADI scores were compared to the national median value. Univariable and multivariable logistic regression analyses were performed to assess the association between the ADI and advanced disease after adjusting for relevant covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 353 patients (median age, 72 years; 84.4% White), the median ADI score was 69. Patients were stratified into two groups on the basis of the national median; 76% were in the high\u2010ADI group. Black patients were more prevalent in the higher ADI group (15.3% vs. 2.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.003). Advanced\u2010stage penile cancer was more frequent in the higher ADI group (49.3% vs. 36.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.04). In multivariable analysis, each 10\u2010point increase in the ADI was associated with 1.16\u2010fold increased odds of advanced\u2010stage disease (95% CI, 1.04\u20131.29;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Greater neighborhood\u2010level socioeconomic deprivation is associated with advanced\u2010stage disease at penile cancer diagnosis. These findings emphasize the role of social determinants in disease presentation, and may guide targeted interventions in disadvantaged populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70241","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T05:37:59Z","timestamp":1766986679000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of the Area Deprivation Index on stage at diagnosis in penile squamous cell carcinoma: A statewide cohort analysis"],"prefix":"10.1002","volume":"132","author":[{"given":"Carlo","family":"Silvani","sequence":"first","affiliation":[{"name":"Vattikuti Urology Institute Center for Outcomes Research Analysis, and Evaluation Henry Ford Health System  Detroit Michigan USA"},{"name":"Urology Unit Fondazione IRCCS Istituto Nazionale dei Tumori  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Tylecki","sequence":"additional","affiliation":[{"name":"Public Health Sciences Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Vattikuti Urology Institute Center for Outcomes Research Analysis, and Evaluation Henry Ford Health System  Detroit Michigan USA"},{"name":"Unit of Urology Division of Oncology IRCCS Ospedale San Raffaele Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Stephens","sequence":"additional","affiliation":[{"name":"Public Health Sciences Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Considine","sequence":"additional","affiliation":[{"name":"Vattikuti Urology Institute Center for Outcomes Research Analysis, and Evaluation Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Redi","family":"Gishto","sequence":"additional","affiliation":[{"name":"Vattikuti Urology Institute Center for Outcomes Research Analysis, and Evaluation Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myles","family":"Perry","sequence":"additional","affiliation":[{"name":"Vattikuti Urology Institute Center for Outcomes Research Analysis, and Evaluation Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Nazzani","sequence":"additional","affiliation":[{"name":"Urology Unit Fondazione IRCCS Istituto Nazionale dei Tumori  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Briganti","sequence":"additional","affiliation":[{"name":"Unit of Urology Division of Oncology IRCCS Ospedale San Raffaele Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Salonia","sequence":"additional","affiliation":[{"name":"Unit of Urology Division of Oncology IRCCS Ospedale San Raffaele Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Montorsi","sequence":"additional","affiliation":[{"name":"Unit of Urology Division of Oncology IRCCS Ospedale San Raffaele Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Nicolai","sequence":"additional","affiliation":[{"name":"Urology Unit Fondazione IRCCS Istituto Nazionale dei Tumori  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Montanari","sequence":"additional","affiliation":[{"name":"Department of 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