ASCO 2021: Prostate Cancer Treatment Disparities During First Wave of COVID-19 Pandemic
Posted: Friday, July 2, 2021
A multi-institutional regional collaborative analysis, which was presented during the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 6542), investigated the racial impact on prostate cancer surgery during the first wave of the COVID-19 pandemic. Adrien Bernstein, MD, of the Fox Chase Cancer Center, Philadelphia, and colleagues explained that the odds of undergoing surgery seemed to decline among Black patients alone.
“We need to be cognizant of the disparate unintended consequence of the diversion of cancer resources to the pandemic,” commented Dr. Bernstein in an institutional press release. “Different policies were enacted for different communities requiring balanced mitigation strategies, lest we see the prostate cancer mortality gap start to widen again.”
Using data from the Pennsylvania Urologic Regional Collaborative database, the investigators identified Black and White patients who had untreated nonmetastatic prostate cancer during the initial lockdown of the pandemic (March–May, 2020: n = 269) or the year prior (March–May, 2019: n = 378).
Despite similar COVID-19 risk factors, biopsy Gleason grade groups, and comparable surgery rates prior to the pandemic (17.7% vs. 19.1%; P = .75), Black men seemed to be significantly less likely to undergo prostatectomy than White patients (1.3% vs. 25.9%; P < .001). White men had lower prebiopsy prostate-specific antigen levels (7.2 vs. 8.8; P = .04), with results trending toward older age (< 60: 24.4% vs. 38.2%; P = .09). Based on the regression model and after adjustments were made for covariates, there was a 94% decline in the odds of undergoing surgery for Black patients (odds ratio = 0.06; P = .006). On the other hand, the investigators reported a nonsignificant increase for White patients (odds ratio = 1.41; P = .142).
Furthermore, changes in surgical volume varied by site. The sites that experienced the largest reduction in cancer surgery seemed to care for a greater proportion of Black patients.
Disclosure: Dr. Bernstein reported no conflicts of interest. For full disclosures of the other study authors, visit coi.asco.org.
