Details

Autor(en) / Beteiligte

• Wen, Wanqing
• Luckenbaugh, Amy N.
• Bayley, Christina E.
• Penson, David F.
• Shu, Xiao‐Ou

Titel

Racial disparities in mortality for patients with prostate cancer after radical prostatectomy

Ist Teil von

• Cancer, 2021-05, Vol.127 (9), p.1517-1528

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek (Open access)

Beschreibungen/Notizen

• Background Although racial disparities in prostate cancer survival are well documented, the relative importance of contributing factors remains unclear. Few studies have examined the disparity between Whites and Hispanics or between Whites and Asian Americans and Pacific Islanders (AAPIs). Methods Using data from the National Cancer Database for 526,690 patients with prostate cancer who underwent radical prostatectomy between 2004 and 2014, this study systematically evaluated the impact of clinical characteristics and factors related to access to care on survival by race. Included in the analysis were 432,640 White patients (82.1%), 63,602 Black patients (12.1%), 8990 AAPI patients (1.7%), and 21,458 Hispanic patients (4.1%). Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals to measure racial survival disparities. Inverse probability weighting was used to adjust for imbalances of prognostic factors. Results When adjustments were made for age and year of diagnosis only, Blacks had 51% higher mortality, AAPIs had 22% lower mortality, and Hispanics had 6% lower mortality than Whites. Overall, with adjustments for all clinical factors and nonclinical factors, the Black‐White survival disparity narrowed to 20%, whereas the AAPI‐White disparity increased to 35%. Among the controlled‐for factors, education, median household income, and insurance status contributed the most to the racial disparity. Conclusions The overall survival disparity among men undergoing radical prostatectomy was significantly decreased, but not eliminated, for Blacks and significantly increased for AAPIs in comparison with Whites after adjustments for a number of clinical factors and factors related to access to care. The overall survival disparity among men undergoing radical prostatectomy is significantly decreased, but not eliminated, for Blacks and significantly increased for Asian Americans and Pacific Islanders in comparison with Whites after adjustments for a number of clinical factors and factors related to access to care. Further research is needed to address how these factors and modifiable lifestyle factors contribute to racial disparities in the overall survival of patients with prostate cancer.