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Prostate Cancer Treatment Patterns and Inequities Among Racial Groups in Brazil's Public Health System: Insights From
Daniel Herchenhorn1,2, Haonne Abboud1,2, Vinicius Freire1
1Oncologia DOr/IDOR, Rio de Janeiro, Brazil.
Race impacts prostate cancer diagnosis and treatment in Brazil. Non-White men present with advanced stages, and treatment patterns differ, highlighting disparities in care within the Brazilian Public Health System.
Area of Science:
- Oncology
- Public Health
- Health Disparities
Background:
- The Brazilian Public Health System (BPHS) covers approximately 77% of the population, offering a unique dataset for national health assessments.
- Prostate cancer (PCa) is a significant health concern, necessitating analysis of epidemiological trends, treatment patterns, and costs.
Purpose of the Study:
- To analyze the impact of race on prostate cancer diagnosis, treatment delivery, and associated healthcare costs within the BPHS.
- To identify potential disparities in prostate cancer care based on racial demographics.
Main Methods:
- Retrospective, population-based cohort study utilizing linked administrative data from the BPHS Database DATASUS (2008-2023).
- Analysis of variables including demographics, clinical features, disease stage, treatment modalities, and healthcare utilization.
- Primary focus on evaluating the influence of race on key prostate cancer outcomes.
Main Results:
- A cohort of 670,205 prostate cancer patients was analyzed; 58.6% were non-White.
- Non-White men were more likely to be diagnosed with advanced-stage disease (P < .001).
- Treatment patterns varied by race, with differences in local therapy administration and significant underuse of docetaxel in metastatic cases (17.8%). Mean costs were 16.2% higher for White patients.
Conclusions:
- Race is significantly associated with advanced prostate cancer stage at diagnosis and varied treatment delivery within the BPHS.
- Identified gaps in care include high rates of de novo metastatic disease and suboptimal use of evidence-based treatments.
- Findings underscore the need for policy interventions to address prostate cancer care disparities in Brazil and similar healthcare systems.
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