Study Finds Regional Variations in Race-Based Survival Differences in Prostate Cancer
Posted: Monday, July 6, 2020
Black patients with low-risk prostate cancer seem to have an increased mortality risk compared with white patients who have low-risk prostate cancer, according to a population-based study published in JAMA Network Open. In addition, this increased risk for black patients with low-risk prostate cancer appears to persist across various geographic regions.
“These findings suggest that race-based survival differences in prostate cancer vary regionally, which may allow for targeted interventions to mitigate these disparities,” reported Sean A. Fletcher, MD, of Harvard Medical School, Boston, and colleagues.
From 2007 to 2014, a total of 229,771 white (n = 178,204), black (n = 35,006), and men of other or unknown races (n = 16,561) with low-risk prostate cancer were enrolled in the study. Patient data were collected from 17 geographic regions utilizing the Surveillance, Epidemiology, and End Results (SEER) database. All patients had a biopsy-confirmed prostate cancer diagnosis prior to participation in the study.
The investigators reported 1,250 and 4,773 prostate cancer deaths among black and white men, respectively. Black men had an overall higher mortality risk than did white men. In addition, these racial differences seemed to persist in individuals with Gleason grade group 1 disease compared with those with Gleason grade groups 2 through 5, with a more pronounced difference in patients in Gleason grade group 1. “The greatest race-based survival difference for men with Gleason grade group 1 disease was in the Atlanta registry,” they reported. Based on stratified analysis, four registries showed worse prostate cancer–specific survival in black men: Atlanta (adjusted hazard ratio [HR] = 5.49), Greater Georgia (adjusted HR = 1.88), Louisiana (adjusted HR = 1.80), and New Jersey (adjusted HR = 2.60).
Disclosure: For full disclosures of the authors, visit jamanetwork.com.