Re-Examining Racial Disparities in Prostate Cancer Outcomes

Cooperberg, Matthew R.

doi:10.1200/jco.2013.50.7723

Cited by 18 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In general, AA men are often diagnosed with more advanced and aggressive prostate cancer compared to any other racial/ethnic groups. However, the observed greater mortality rates in these men can only partially be explained by the characteristics of tumors at the time of diagnosis (4). …”

Section: Introductionmentioning

confidence: 99%

Racial disparities in prostate cancer a molecular perspective

et al. 2017

View full text Add to dashboard Cite

Prostate cancer incidence and mortality rates are remarkably higher in African-American men as compared to their European-Americans counterparts. Despite these recognitions, precise causes underlying such prevalent racial disparities remain poorly understood. Although socioeconomic factors could account for such differences up to a certain extent, it is now being increasingly realized that such disparity has a molecular basis. Indeed, several differences, including genetic polymorphism, gene mutations, epigenetic modifications, miRNAs alterations, etc., have been reported in malignant prostate tissues from patients of diverse racial backgrounds. Here, we attempt to provide a molecular perspective on prostate cancer racial disparities by gathering available information on these associated factors and discussing their potential significance in disproportionate incidence and clinical outcomes.

show abstract

Section: Introductionmentioning

confidence: 99%

Racial disparities in prostate cancer a molecular perspective

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Significantly fewer Black men in the HGPC cohort were treated with RP, opting for XRT‐ADT or primary ADT. Identifying reasons for this observation are beyond the scope of this study, however previous analyses indicate that they are likely multifactorial . Dedicated studies focused on close examination of PC racial disparities within the VA are needed in order to better understand a potential impact on tumor biology and/or clinical outcome.…”

Section: Discussionmentioning

confidence: 93%

Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer

et al. 2016

View full text Add to dashboard Cite

Men with high‐grade prostate cancer (HGPC) are at greatest risk of disease progression. Clinical risk factors associated with castration‐resistant prostate cancer (CRPC), metastases, and prostate cancer‐specific mortality (PCSM) were identified in a contemporary HGPC cohort. Clinical data was collected from men diagnosed with Gleason sum (GS) ≥8 at the Greater Los Angeles Veterans Affairs (GLA‐VA) Healthcare System between 2000 and 2013. Multivariable competing risks regression analyses assessed progression to CRPC, metastases, and PCSM within three treatment strata. The cumulative incidence of disease progression was calculated at 2, 5, and 10‐year time points. Review of 2149 prostate cancer cases yielded 322 with HGPC. Median survival times for cancer‐specific and overall mortality were significantly shorter in men treated with primary androgen deprivation therapy (ADT) (P = 0.0002 and P < 0.0001). Multivariable analyses revealed that clinical stage N1, GS 10, and treatment with primary ADT were significantly associated with increased risk of CRPC, metastases, and PCSM. Significant differences in these outcomes were not observed in men treated with radical prostatectomy (RP) when compared to those treated with radiation therapy combined with short‐term ADT (XRT‐ADT). Ten‐year event rates of progression to CRPC, metastases, and PCSM, for men treated with primary ADT, were 45.5%, 25.4%, and 25.1%, respectively. In conclusion, GS 10 and lymph node involvement, as well as primary ADT treatment in men with HGPC was associated with increased risk of CRPC, metastases, and PCSM. Curative‐intent treatment with RP or XRT‐ADT is associated with reduced progression rates and death in men with HGPC.

show abstract

“…These results are important as clinicians may be increasingly hesitant to require men to have serial re-biopsies due to complications. Yet, Black men are known to have a greater likelihood of PCa progression, 28, 29 which suggests that clinicians should be cautious about placing men on AS until better methods are devised to improve monitoring men on AS.…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic and Clinical Predictors of Switching to Active Treatment among a Large, Ethnically Diverse Cohort of Men with Low Risk Prostate Cancer on Observational Management

et al. 2016

View full text Add to dashboard Cite

Purpose To determine the clinical and sociodemographic predictors of beginning an active treatment among an ethnically diverse population of men with low-risk prostate cancer initially on observational management. Materials and Methods We retrospectively studied men diagnosed with low-risk prostate cancer between 2004 and 2012 at Kaiser Permanente Northern California, who did not receive any treatment within the first year of diagnosis and had at least two years of follow-up. We used Cox proportional hazards regression models to determine factors associated with time from diagnosis until active treatment. Results We identified 2,228 eligible men who were initially on observation, and 27% began an active treatment during follow-up (median 2.9 years). Non-Hispanic Black men were marginally more likely to begin an active treatment (hazard ratio [HR] 1.3, 95% CI 1.0–1.7) than non-Hispanic White men, independent of baseline and follow-up clinical measures. Among men who remained on observation, non-Hispanic Black men were re-biopsied within 24 months of diagnosis at slightly lower rates than non-Hispanic White men (HR 0.70, 95% CI 0.6–1.0). Gleason grade progression (HR 3.3, 95% CI 2.7–4.1) and a PSA doubling time < 48 months (HR 2.9, 95% CI 2.3–3. 7) were associated with initiation of active treatment, independent of race. Conclusions Sociodemographic factors, such as ethnicity and education, may independently influence a patient's decision to pursue active treatment and their utilization of serial biopsies during active surveillance. These factors are important in further studies of prostate cancer treatment decision making.

show abstract

Re-Examining Racial Disparities in Prostate Cancer Outcomes

Cited by 18 publications

References 17 publications

Racial disparities in prostate cancer a molecular perspective

Racial disparities in prostate cancer a molecular perspective

Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer

Sociodemographic and Clinical Predictors of Switching to Active Treatment among a Large, Ethnically Diverse Cohort of Men with Low Risk Prostate Cancer on Observational Management

Contact Info

Product

Resources

About