Stage-Specific Racial Disparities in Prostate Cancer Survival Outcomes

Racial disparities in prostate cancer (PCa) survival are inconsistently reported.

We evaluated long-term survival in 976 men from the NCI-Maryland PCa case-control study, stratified by disease stage.

There were no survival differences observed between African American (AA) and European American (EA) men with Stage 1 or 2 disease. In contrast, AA men with Stage 3 or 4 PCa experienced significantly higher prostate cancer-specific and all-cause mortality in equal-access Veterans Affairs (VA) and non-VA settings. Adjustment for baseline prostate-specific antigen (PSA) level, Gleason score, and treatment modalities attenuated but did not eliminate these differences.

Disparate survival outcomes for AA men with PCa emerge mainly at Stage 3 or 4 diagnosis, emphasizing the importance of early detection for these men. Notably, AA patients with advanced-stage disease were more likely to receive hormone therapy alone, a treatment pattern that may contribute to racial disparities in PCa survival.