Utilization and Cancer Control Outcomes of Active Surveillance Amongst Black and White Men with Intermediate Risk...

To assess the utilization and prostate cancer (PCa)-specific mortality (PCSM) between non-Hispanic Black (NHB) and non-Hispanic White (NHW) on active surveillance (AS) with intermediate risk PCa (iPCa).

The Surveillance, Epidemiology, and End Results database was queried between 2010-2016. The rate of AS was calculated per year between NHB and NHW using univariable logistic analysis (UVA) and multivariable logistic analysis (MVA). Next, inverse probability of treatment weighting was performed on those that underwent watchful waiting (WW) and competing-risks cumulative incidence function (CIF) and MVA were used to assess the impact of race on other-cause mortality (OCM) and PCSM. Statistical significance defined as p < 0.05, but some observations were deemed non-statistically significant per our Benjamini-Hochberg procedures, RESULTS: 50,315 patients had iPCa, and 3,310 underwent AS/WW. The rate of AS increased amongst NHB (+ 3.1%) and NHW (+ 5.7%) from 2010 - 2016. UVA did not show an association with race, but MVA showed a negative association, based on our Benjamini-Hochberg correction, between NHB and AS [OR 0.68 (95% CI: 5.4-0.87; p = 0.002)]. On CIF, NHB and NHW had non-significant differences in OCM in the weighted cohort (p = 0.03), due to the Benjamini-Hochberg correction, and that was confirmed with MVA with a HR of 1.23 (95% CI: 1.02-1.49; p = 0.03). However, the CIF on PCSM showed NHB had a higher risk of PCSM (p < 0.0001), and that was confirmed with MVA with a HR of 3.01 (95% CI: 2.00-4.53; p < 0.001).

The utilization of AS for iPCa increased amongst NHB and NHW patients. Unfortunately, NHB race was associated with increased risk of PCSM from one year to the next compared to NHW patients.