Overall Survival and Associations of Insurance Status Among Hispanic Men With High-Risk Prostate Cancer

Area of Science:

• Urology
• Oncology
• Health Services Research

Background:

• Prostate cancer (PCa) disproportionately affects various racial and ethnic groups.
• Understanding survival disparities in high-risk PCa is crucial for equitable healthcare.
• Socioeconomic factors and insurance status may influence PCa outcomes.

Purpose of the Study:

• To investigate the association between race/ethnicity and overall survival (OS) in men with high-risk prostate cancer.
• To determine if insurance status modifies the relationship between ethnicity and PCa survival.
• To identify potential disparities in PCa outcomes among different demographic groups.

Main Methods:

• Retrospective analysis of the National Cancer Database (NCDB) from 2004-2017.
• Inclusion of non-Hispanic White (NHW), Hispanic White (HW), and Black men diagnosed with high-risk PCa.
• Multivariate Cox regression modeling to assess OS, race/ethnicity, insurance status, and interactions, controlling for covariates.

Main Results:

• Analysis included 94,708 men with high-risk PCa.
• HW and Black men reported lower socioeconomic status and less private insurance.
• NHW and Black men had significantly worse OS compared to HW men (aHRs > 1).
• Medicare was associated with significantly worse OS.
• HW men with private insurance showed better survival compared to other insurance types within their group.

Conclusions:

• Hispanic White men with high-risk PCa exhibit improved overall survival compared to non-Hispanic White men.
• This survival advantage for HW men persists across most insurance types.
• The findings suggest a complex interplay of factors influencing PCa survival and warrant further investigation.