Income inequality and treatment of African American men with high-risk prostate cancer

Ziehr, David R.; Mahal, Brandon A.; Aizer, Ayal A.; Hyatt, Andrew S.; Beard, Clair J.; D’Amico, Anthony V.; Choueiri, Toni K.; Elfiky, Aymen; Lathan, Christopher S.; Martin, Neil E.; Sweeney, Christopher J.; Trinh, Quoc‐Dien; Nguyen, Paul L.

doi:10.1016/j.urolonc.2014.09.005

Cited by 59 publications

(44 citation statements)

References 30 publications

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“…Potential risk factors and prognostic factors can be identified from these data as well [13]. In addition, they might be useful for assessment of trends in the adoption of screening, diagnostic, and treatment procedures, as well as novel technologies [54,56,58,[60][61][62][63][64][65][66][67]. For example, Vickers et al [68] demonstrated that restriction of PSA testing to only young men or selected men aged >70 yr might reduce the risk of overdiagnosis.…”

Section: 4mentioning

confidence: 99%

“…Disparities and variations in the use of imaging and treatment modalities can also be evaluated using diseasespecific registries. In particular, these databases allow examination of the relationship between baseline characteristics and the likelihood of receiving proper staging or adequate treatment [54,56,58,[60][61][62][63][64][65][66][67]. A recent CaPSURE study demonstrated substantial differences in primary treatment between African-American and white men with similar risk profiles [54].…”

Section: 4mentioning

confidence: 99%

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Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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Context: Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. Objective: To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. Evidence acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms prostate cancer, outcomes, statistical approaches, population-based cohorts, registries of outcomes, and epidemiological studies, alone or in combination. We limited our search to studies published between January 2005 and January 2015. Evidence synthesis: Several population-based and prospective disease-specific registries are currently available for prostate cancer. Studies performed using these data sources provide important information on incidence and mortality, disease characteristics at presentation, risk factors, trends in utilization of health care services, disparities in access to treatment, quality of care, long-term oncologic and health-related quality of life outcomes, and costs associated with management of the disease. Although data from these registries have some limitations, statistical methods are available that can address certain biases and increase the internal and external validity of such analyses. In the future, improvements in data quality, collection of tissue samples, and the availability of data feedback to health care providers will increase the relevance of studies built on population-based and disease-specific registries. Conclusions: The strengths and limitations of PCa registries should be carefully considered when planning studies using these databases. Although randomized controlled trials still provide the highest level of evidence, large registries play an important and growing role in advancing PCa research and care. Patient summary: Several population-based and prospective disease-specific registries for prostate cancer are currently available. Analyses of data from these registries yield information that is clinically relevant for the management of patients with prostate cancer.

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Section: 4mentioning

confidence: 99%

Section: 4mentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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“…Among African-American men receiving definitive therapy, radiation is more common than surgery 75,76,79 , and in those who undergo surgery, differences in surgical quality, oncological outcomes, and quality of life have emerged [80][81][82][83][84][85] . Generally, differences in biology might contribute to a later stage of disease at presentation resulting in poorer outcomes, but the contribution of the availability of early diagnosis and treatment to this disparity remains to be defined.…”

Section: Treatment Selectionmentioning

confidence: 99%

“…In the new millennium, after controlling for sociodemographic factors, African-American men continued to be less likely to pursue surgical therapy for prostate cancer management (23.2% versus 25.9%) within the equal access Veterans Affairs system 97 . In 2015, Ziehr et al 79 used SEER data to evaluate the effect of race on treatment selection for 102,486 men diagnosed with high-risk prostate cancer (PSA >20 ng/ml or Gleason≥8 or stage ≥cT2c) between 2004 and 2010. Within this group, African-American men were significantly less likely to be recommended surgery (OR 1.86, 95% CI 1.78-1.94; P <0.001) and were more likely to refuse surgery (OR 1.71, 95% CI 1.44-2.04; P <0.001) than white men.…”

Section: Treatment Outcome Differences For Localized Cancermentioning

confidence: 99%

Prostate cancer in men of African origin

2015

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Men of African origin are disproportionately affected by prostate cancer: prostate cancer incidence is highest among men of African origin in the USA, prostate cancer mortality is highest among men of African origin in the Caribbean, and tumour stage and grade at diagnosis are highest among men in sub-Saharan Africa. Socioeconomic, educational, cultural, and genetic factors, as well as variations in care delivery and treatment selection, contribute to this cancer disparity. Emerging data on single-nucleotide-polymorphism patterns, epigenetic changes, and variations in fusion-gene products among men of African origin add to the understanding of genetic differences underlying this disease. On the diagnosis of prostate cancer, when all treatment options are available, men of African origin are more likely to choose radiation therapy or to receive no definitive treatment than white men. Among men of African origin undergoing surgery, increased rates of biochemical recurrence have been identified. Understanding differences in the cancer-survivorship experience and quality-of-life outcomes among men of African origin are critical to appropriately counsel patients and improve cultural sensitivity. Efforts to curtail prostate cancer screening will likely affect men of African origin disproportionately and widen the racial disparity of disease.

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“…[16][17][18] Few studies utilize both individual-level and area-level data. 19,20 Yet, research increasingly recognizes that different dimensions of SES are not interchangeable, [21][22][23] and it is believed that different socioeconomic factors may provide unique information related to health disparities.…”

Section: Race Ses and Prostate Cancer Treatment -Watson Et Almentioning

confidence: 99%

Racial Differences in Prostate Cancer Treatment: The Role of Socioeconomic Status

et al. 2017

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Objective: This study examines whether socioeconomic status (SES), measured at both the individual and neighborhood levels, is associated with receipt of definitive treatment for localized prostate cancer and whether these associations mediate racial differences in treatment between non-Hispanic White and non-Hispanic Black men. Design: The Philadelphia Area Prostate Cancer Access Study (P2 Access) is a mailed, cross-sectional survey of men sampled from the Pennsylvania Cancer Registry, combined with neighborhood Census data. Setting: Eight counties in southeastern Pennsylvania. Participants: 2,386 men with prostate adenocarcinoma. Main Measures: Receipt of definitive treatment, race, self-reported income, education, employment status, and neighborhood SES. Results: Overall, Black and White men were equally likely to receive definitive treatment. Men living in neighborhoods with higher SES were more likely to receive definitive treatment (OR 1.57, 95%CI 1.01, 2.42). Among men who received definitive treatment, Black men were significantly less likely to receive radical prostatectomy compared with White men (OR .71, 95% CI .52, .98), as were men with some college education compared with those with a high school education or less (OR .66, 95% CI .47, .94). SES does not mediate racial differences in receipt of definitive treatment or the type of definitive treatment received, and associations with income or employment status were not significant. Conclusions: These results stress the importance of examining racial disparities within geographic areas and highlight the unique associations that different measures of SES, particularly neighborhood SES and education, may have with prostate cancer treatment.Ethn Dis. 2017;27(3):201-208; doi:10.18865/ed.27.3.201.

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Income inequality and treatment of African American men with high-risk prostate cancer

Cited by 59 publications

References 30 publications

Prostate Cancer Registries: Current Status and Future Directions

Prostate Cancer Registries: Current Status and Future Directions

Prostate cancer in men of African origin

Racial Differences in Prostate Cancer Treatment: The Role of Socioeconomic Status

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