Race, socioeconomic status, and other prognostic factors for survival from prostate cancer

Survival data on prostate cancer patients from 11 Comprehensive Cancer Centers contributing data to the Centralized Cancer Patient Data System were analyzed to examine the contribution of various factors to the probability of survival from prostate carcinoma. Application of a number of exclusion criteria resulted in a series of 2,513 patients (1,032 blacks and 1,481 Caucasians) for whom complete data on variables of interest were available. The stage of disease at diagnosis was a major determinant of survival. The proportion of blacks presenting the disease in advanced stage was substantially higher than that of Caucasians--a difference which was maintained within each socio-economic status (SES) category. Caucasian patients had a better prognosis than blacks for each disease stage. A dose-response relationship between SES and survival prognosis was observed and this relationship persisted for each stage of the disease. Although both race and SES turned out to be significant in regression models in which one or the other was considered, the model including both race and SES showed only SES to be a significant factor. Hence it can be hypothesized that the racial difference in the survival prognosis for prostate cancer is, to a large extent due to the differences in the distribution of SES in the two races.