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miRNA Expression Analyses in Prostate Cancer Clinical Tissues
11:29

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Published on: September 8, 2015

Explaining racial differences in prostate cancer mortality.

Glen B Taksler1, Nancy L Keating, David M Cutler

  • 1Department of Medicine, New York University School of Medicine, New York, New York, USA.

Cancer
|January 17, 2012
PubMed
Summary
This summary is machine-generated.

Black men face a significantly higher prostate cancer death rate. This disparity stems from both higher incidence and more advanced disease at diagnosis, highlighting the need for earlier screening and treatment.

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Area of Science:

  • Oncology
  • Public Health
  • Health Disparities

Background:

  • Black males exhibit a 2.4-fold higher annual prostate cancer death rate compared to white males in the U.S.
  • The underlying causes for this significant racial disparity in prostate cancer mortality remain largely unelucidated.

Purpose of the Study:

  • To investigate and quantify the racial gap in prostate cancer mortality among older men.
  • To decompose the mortality gap into components of cancer incidence and stage-specific mortality.
  • To examine the influence of clinical and socioeconomic factors on these components.

Main Methods:

  • Analysis of the Surveillance, Epidemiology, and End Results-Medicare database (1995-2005).
  • Inclusion of 77,038 black and white males aged over 65 with prostate cancer diagnosis and 49,769 controls.
  • Decomposition of the mortality gap and examination of contributing factors.

Main Results:

  • A prostate cancer-specific mortality gap of 1320 excess cases per 100,000 males among black men.
  • Higher incidence accounted for 76% of the gap; higher stage-specific mortality accounted for 24%.
  • Factors like PSA testing, comorbidities, and income explained 29% of metastatic incidence differences but not local/regional incidence gaps. Tumor characteristics, treatment choices, and socioeconomic factors explained significant portions of the gap conditional on diagnosis.

Conclusions:

  • Increased prostate-specific antigen (PSA) testing for black and low-income males may reduce mortality through earlier diagnosis.
  • More aggressive prostate cancer treatment, particularly in underserved communities, could help narrow the racial mortality gap.