TY - JOUR
T1 - Racial disparities in prostate cancere specific mortality in men with low-risk prostate cancer
AU - Mahal, Brandon A.
AU - Aizer, Ayal A.
AU - Ziehr, David R.
AU - Hyatt, Andrew S.
AU - Choueiri, Toni K.
AU - Hu, Jim C.
AU - Hoffman, Karen E.
AU - Sweeney, Christopher J.
AU - Beard, Clair J.
AU - D'Amico, Anthony V.
AU - Martin, Neil E.
AU - Kim, Simon P.
AU - Trinh, Quoc Dien
AU - Nguyen, Paul L.
N1 - Funding Information:
This work was supported by David and Cynthia Chapin , the Prostate Cancer Foundation , Fitz’s Cancer Warriors , Hugh Simons in Honor of Frank and Anne Simons , and a grant from an anonymous family foundation . Paul L. Nguyen served on an advisory board for Astellas Pharmaceuticals in June 2013. Quoc-Dien Trinh lectured on behalf of Intuitive Surgical. All other authors state that they have no conflicts of interest.
Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014
Y1 - 2014
N2 - This study examined the association of race and prostate cancerespecific mortality (PCSM) in 51,315 men with low-risk prostate cancer, using the Surveillance, Epidemiology, and End Results (SEER) database. African American men were found to have a higher risk of PCSM compared with white men, suggesting that further studies are needed to determine whether guidelines for active surveillance should take race into account. Background: Men with low-risk prostate cancer (CaP) are considered unlikely to die of CaP and have the option of active surveillance. This study evaluated whether African American (AA) men who present with low-risk disease are at higher risk for death from CaP than white men. Patients and Methods: The authors identified 56,045 men with lowrisk CaP (T1-T2a, Gleason score ≤ 6, prostate-specific antigen ≤ 10 ng/mL) diagnosed between 2004 and 2009 using the Surveillance, Epidemiology, and End Results (SEER) database. Fine-Gray competing-risks regression analyses were used to analyze the effect of race on prostate cancerespecific mortality (PCSM) after adjusting for known prognostic and sociodemographic factors in 51,315 men (43,792 white; 7523 AA) with clinical follow-up information available. Results: After a median follow-up of 46 months, 258 patients (209 [0.48%] white and 49 [0.65%] AA men) died from CaP. Both AA race (adjusted hazard ratio [AHR], 1.45; 95% CI, 1.03-2.05; P = .032) and noncurative management (AHR, 1.49; 95% CI, 1.15-1.95; P = .003) were significantly associated with an increased risk of PCSM. When analyzing only patients who underwent curative treatment, AA race (AHR, 1.62; 95% CI, 1.04-2.53; P = .034) remained significantly associated with increased PCSM. Conclusion: Among men with low-risk prostate cancer, AA race compared with white race was associated with a higher risk of PCSM, raising the possibility that clinicians may need to exercise caution when recommending active surveillance for AA men with low-risk disease. Further studies are needed to ultimately determine whether guidelines for active surveillance should take race into account.
AB - This study examined the association of race and prostate cancerespecific mortality (PCSM) in 51,315 men with low-risk prostate cancer, using the Surveillance, Epidemiology, and End Results (SEER) database. African American men were found to have a higher risk of PCSM compared with white men, suggesting that further studies are needed to determine whether guidelines for active surveillance should take race into account. Background: Men with low-risk prostate cancer (CaP) are considered unlikely to die of CaP and have the option of active surveillance. This study evaluated whether African American (AA) men who present with low-risk disease are at higher risk for death from CaP than white men. Patients and Methods: The authors identified 56,045 men with lowrisk CaP (T1-T2a, Gleason score ≤ 6, prostate-specific antigen ≤ 10 ng/mL) diagnosed between 2004 and 2009 using the Surveillance, Epidemiology, and End Results (SEER) database. Fine-Gray competing-risks regression analyses were used to analyze the effect of race on prostate cancerespecific mortality (PCSM) after adjusting for known prognostic and sociodemographic factors in 51,315 men (43,792 white; 7523 AA) with clinical follow-up information available. Results: After a median follow-up of 46 months, 258 patients (209 [0.48%] white and 49 [0.65%] AA men) died from CaP. Both AA race (adjusted hazard ratio [AHR], 1.45; 95% CI, 1.03-2.05; P = .032) and noncurative management (AHR, 1.49; 95% CI, 1.15-1.95; P = .003) were significantly associated with an increased risk of PCSM. When analyzing only patients who underwent curative treatment, AA race (AHR, 1.62; 95% CI, 1.04-2.53; P = .034) remained significantly associated with increased PCSM. Conclusion: Among men with low-risk prostate cancer, AA race compared with white race was associated with a higher risk of PCSM, raising the possibility that clinicians may need to exercise caution when recommending active surveillance for AA men with low-risk disease. Further studies are needed to ultimately determine whether guidelines for active surveillance should take race into account.
KW - African-American
KW - Health Policy
KW - Population health
KW - Prostatic Neoplasms
KW - SEER
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U2 - 10.1016/j.clgc.2014.04.003
DO - 10.1016/j.clgc.2014.04.003
M3 - Article
C2 - 24861952
AN - SCOPUS:84922665539
SN - 1558-7673
VL - 12
SP - e189-e195
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 5
ER -