Although racial disparities in prostate cancer survival are well documented, the relative importance of contributing factors remains unclear.
To investigate the potential causes behind such disparities, Wanqing Wen, MD, MPH, of Vanderbilt University School of Medicine in Nashville, Tennessee, and his colleagues examined information from the National Cancer Database, which includes cancer registry data from more than 1,500 U.S. facilities.
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"Socioeconomic status and insurance status are all changeable factors", study co-author Dr. Wanqing Wen, a research associate professor of medicine at Vanderbilt University School of Medicine, said in a press release.
However, if Black Americans and White Americans had similar education levels, median household income and insurance status, the gap in the death rate would drop from 51% to 30%, the researchers said. 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%).
After adjusting for age and year of prostate cancer diagnosis, the researchers found that Blacks had a 51% higher death rate than whites, while AAPIs and Hispanics had 22% and 6% lower rates than whites, respectively.
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. "We hope our study findings can enhance public awareness that the racial survival difference, particularly between Black and white prostate patients, can be narrowed by erasing the racial inequities in socioeconomic status and health care. Effectively disseminating our findings to the public and policymakers is an important step towards this goal".