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Factors contributing to the racial differences in prostate cancer mortality
Ashutosh Tewari1, Wolfgang Horninger, Alexandre E Pelzer
1Vattikuti Urology Institute and Josephine Ford Cancer Center, Henry Ford Health System, Detroit, MI, USA.
BJU International
|November 17, 2005
Summary
African-Americans have lower prostate cancer survival rates, largely due to socioeconomic factors and less frequent surgical treatment. Increasing awareness of treatment options may improve survival outcomes for this group.
Area of Science:
- Oncology
- Health Disparities
- Surgical Oncology
Background:
- Prostate cancer survival rates exhibit significant disparities between racial groups.
- Socioeconomic status (SES) and treatment modality are potential contributing factors to these disparities.
Purpose of the Study:
- To investigate differences in prostate cancer surgical treatment rates between African-American and White American men.
- To assess the association between these treatment differences and survival rate disparities.
Main Methods:
- Retrospective cohort study of 4279 men with localized prostate cancer (1980-1997).
- Analysis of clinical, pathological, demographic data, including SES and treatment method.
- Kaplan-Meier and Cox proportional hazards models used for survival analysis.
Main Results:
- Surgical treatment rates were 17% for African-Americans versus 28% for Whites (P < 0.001).
- African-Americans had lower survival rates with conservative or radiation therapy.
- No significant survival difference was observed between racial groups for patients undergoing surgery.
- SES and surgical treatment rates explained 50% and 34% of survival differences, respectively.
Conclusions:
- Lower prostate cancer survival in African-Americans is substantially linked to socioeconomic status and reduced surgical treatment rates.
- Enhancing awareness of treatment options among African-American patients could improve survival outcomes.
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