Mp12-19 disparities in Refusal of Systematic Therapy in Metastatic Prostate Cancer

Abstract

found in 367/608 (60%) of the White men and 104/147 (70.8%) of AA men in our series (p[0.02). 224/608 (36.8%) of White men and 74/ 147 (50.3%) of AA men had a Gleason score of 7-10 (p[0.003). Age, DRE status, PIRADS score, and the incidence of Gleason 6 PCa were not found to be significantly different by race. 163/608 (26.8%) of White men and 20/147 (13.6%) of AA men had a PSA upon presentation of 0-3.9 ng/ml (p[0.001). The PSA levels of 4.0-9.9 ng/ml and PSA > 10 ng/ ml at presentation were not significantly different. Of the 73/828 (8.8%) of men who identify as not White and not Black no significant difference was found for any tested factor but interestingly 19/73 (26%) presented with a PSA between 0-3.9 ng/ml versus Black men (p[0.02) which was almost identical to the effect seen relative to White men.CONCLUSIONS: In this dataset, it appears that AA men present with a higher PSA than White men. It is likely that this is related to disparities in access to care rather than biological intrinsic factors. Also, we did observe a higher incidence of Gleason 7-10 PCa in AA men, which one would expect in a cohort of patients who presented for biopsy in the community with a significantly higher PSA at initial presentation. Continuing education of primary care providers regarding the importance of PSA testing in the AA community should be emphasized by both the urological and primary care professional medical societies.