Racial Disparities in Prostate Cancer Treatment During the COVID-19 Pandemic
Posted: Tuesday, September 21, 2021
A recent article published in JAMA Oncology highlighted the racial disparities in prostate cancer care during the first wave of the COVID-19 pandemic. Andres Correa, MD, of Fox Chase Cancer Center, Philadelphia, and colleagues conducted a retrospective cohort study comparing prostatectomy rates between Black and White patients with untreated nonmetastatic prostate cancer during the coronavirus pandemic. Their findings revealed that the odds of prostate cancer surgery were lower among Black patients than their White counterparts. They also found that although there was a pause in cancer surgeries during the early phases of the COVID-19 pandemic, these restrictions were unequally enacted and especially reduced at sites with a higher proportion of Black patients.
“Disparities in surgical treatment were not only associated with changes within individual practices but with systematic variations…. Furthermore, multiple studies have demonstrated that this association between race and care was amplified by preexisting inequalities in housing, employment, and insurance, which may have increased exposure to the virus and restricted subsequent treatment,” stated Dr. Correa and colleagues.
A total of 647 men were enrolled in this study; 172 (26.6%) were non-Hispanic Black men, and 475 (73.4%) were non-Hispanic White men. The investigators compared prostatectomy rates between Black and White patients. For this study, patients self-identified race, and all other ethnicities and races were excluded to minimize heterogeneity.
Overall findings revealed that Black men were significantly less likely to undergo prostatectomy during the COVID-19 pandemic compared with White patients (1 of 76 [1.3%] vs. 50 of 193 [25.9%]; P < .001). They also found that Black men had higher median prostate-specific antigen levels prior to biopsy (8.8 ng/mL [interquartile range, 5.3–15.2 ng/mL] vs. 7.2 ng/mL [interquartile range, 5.1–11.1 ng/mL]; P = .04). Additionally, the odds ratio for likelihood of surgery was 0.06 (95% confidence interval [CI] = 0.01–0.35; P = .002) for Black patients and 1.41 (95% CI = 0.81–2.44; P = .23) for White patients.
Disclosure: For full disclosure of the study authors, visit jamanetwork.com.