Abstract 780: Racial disparities in death from cardiovascular disease for patients with prostate cancer: A population-based study

Abstract

Introduction: Prostate cancer (PCa) is the most common cancer diagnosis among men in the United States. However, a vast majority of patients with PCa die of causes other than PCa, the most common being cardiovascular disease (CVD). We hypothesize that CVD-related mortality in PCa patients is disproportionately higher among Blacks as compared to Whites. Methods: We identified patients with PCa from the Surveillance, Epidemiology and End Results (SEER)-Medicare linked files between 1/1/2004 and 12/31/2015. The PCa risk groups were created based on the National Comprehensive Cancer Network criteria: low, intermediate, and high risk. The primary endpoint was CVD-related mortality. The following CVD conditions were included in the CVD-specific mortality: acute myocardial infarction, stroke, congestive heart failure, atrial fibrillation, and ischemic heart disease. A proportional hazards model that considered the competing risks was fitted to address the hypothesis. The model was adjusted for age, year of diagnosis, marital status, income level, SEER-region, state buy-in, radiation, surgery, and education level. Results: We identified 394,323 patients with PCa. Among these 80% were Whites, 15% were Blacks, and 5% were other races. The median age at diagnosis for Whites, Blacks, and other races was 69, 66, and 70 years, respectively. The incidence of CVD-related mortality was 5.6%, 6.6%, and 5% among Whites, Blacks, and Other races, respectively. Compared to Whites, Blacks had a significantly higher risk of mortality due to CVD across all PCa risk groups (Table). Similar results were not seen when the Other races was compared to Whites. Conclusion: Blacks with PCa have a significantly higher risk of mortality due to CVD as compared to Whites across all PCa risk groups. Our study highlights the importance of cardio-oncology in the setting of PCa. Further studies are warranted to confirm the findings. Table: Risk of CVD-related mortality among PCa patients; stratified by PCa risk group.Low-Risk (N=84,367)Intermediate-Risk(N=146,411)High-Risk(N=96,502)HR (95%CI); p-valueHR (95%CI); p-valueHR (95%CI); p-valueWhites(N=316,803)RefRefRefBlacks(N=58,046)1.23 (1.09-1.39); p<0.0011.24 (1.14-1.34); p<0.0011.09 (1.01-1.20); p=0.029Other Races(N=19,474)0.79 (0.60-1.04); p=0.0890.87 (0.74-1.03); p=0.1120.79 (0.69-0.91); p<0.001 Citation Format: Nikita Nikita, Joshua Banks, Scott Keith, Kosj Yamoah, Ulhas P. Naik, Felix J. Kim, David M. Shipon, Wm Kevin Kelly, Timothy R. Rebbeck, Grace Lu Yao. Racial disparities in death from cardiovascular disease for patients with prostate cancer: A population-based study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 780.