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Published on: March 6, 2018
Racial Differences in Secondary Treatment Pathways and Survival in Localized Prostate Cancer
Jessica Acolin1, Yibai Zhao2, Sarah K Holt3
1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
JAMA Network Open
|July 21, 2026
Summary
Black men face higher prostate cancer mortality. Treatment patterns after initial therapy were similar by race, but disparities in mortality emerged among those not receiving secondary treatment, highlighting potential healthcare inequities.
Area of Science:
- Oncology
- Health Services Research
- Health Equity
Background:
- Black men experience over double the prostate cancer mortality rate compared to White men.
- Understanding the mechanisms behind these racial disparities is crucial for achieving health equity.
Purpose of the Study:
- To compare treatment trajectories and mortality outcomes in Black and White patients with localized prostate cancer after primary treatment.
- To identify potential racial disparities in secondary treatment receipt and their association with survival.
Main Methods:
- Retrospective, population-based cohort study using SEER-Medicare data (2004-2017).
- Included non-Hispanic Black and White men aged 66+ diagnosed with localized prostate cancer.
- Analyzed secondary treatment receipt and mortality outcomes, stratified by primary treatment (surgery or radiation therapy).
Main Results:
- Secondary treatment receipt was similar between Black and White patients after both primary surgery (19.2%) and radiation therapy (28.0%).
- No significant differences in mortality were observed among patients who received secondary treatment, regardless of race.
- However, Black patients who did not receive secondary treatment had a higher risk of both prostate cancer-specific and all-cause mortality.
Conclusions:
- Treatment patterns following primary definitive care for localized prostate cancer were comparable across racial groups.
- While secondary treatment itself did not correlate with mortality differences, disparities in mortality were evident among those not receiving further treatment.
- These findings underscore concerns regarding potential healthcare inequities contributing to observed mortality differences.
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