Evaluation of the contribution of demographics, access to health care, treatment, and tumor characteristics to racial differences in survival of advanced prostate cancer

Prostate Cancer and Prostatic Diseases
Marieke J KrimphoveQuoc-Dien Trinh

Abstract

Racial differences in prostate cancer (PCa) outcomes in the United States may be due to differences in tumor biology and race-based differences in access and treatment. We designed a study to estimate the relative contribution of these factors on Black/White disparities in overall survival (OS) in advanced PCa. We identified Black and White men aged ≥ 40 years with metastatic or locally advanced PCa (cN+ cM+ and/or T3/4) between 2004 and 2010 using the National Cancer Database. We employed sequential propensity score weighting procedures to generate simulated cohorts of Black and White patients with equal demographics, access to care, treatment, and tumor characteristics. Adjusted survival analyses were used to compare survival in these simulated cohorts. The changes in relative survival after each weighting procedure were used to infer the contribution of each set of variables on the excess risk of mortality in Blacks. In total, 35,611 men met inclusion criteria, 5927 (16.77%) of whom were Black. Survival was significantly worse for Black men after adjusting for demographics and comorbidities (hazard ratio (HR) 1.27, 95%-confidence interval (95%-CI) 1.2-1.34, p < 0.001). After simulating equal access to care, there was no sign...Continue Reading

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Citations

Apr 2, 2020·JAMA Network Open·Sean A FletcherQuoc-Dien Trinh
Nov 7, 2019·Prostate Cancer and Prostatic Diseases·Marina DeukerPierre I Karakiewicz
May 30, 2020·Nature Reviews. Clinical Oncology·Farhad IslamiAhmedin Jemal
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Jul 6, 2021·Expert Opinion on Drug Discovery·Elisabete Nascimento-GonçalvesPaula A Oliveira
Nov 27, 2021·The British Journal of Radiology·Alexander P ColeMark Emberton

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Related Concepts

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Cancer Disparities

Cancer disparities refers to differences in cancer outcomes (e.g., number of cancer cases, related health complications) across population groups.

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