Higher PCa Death Risk in Blacks Still Unexplained

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Researchers who conducted a study of prostate cancer (PCa) patients in Kentucky found that African Americans were more likely to die from the cancer than Caucasians, even after controlling for many known predictors of cancer survival.

The study—led by Samuel Antwi, MPH, of the University of South Carolina in Columbia, who collaborated with researchers at the University of Kentucky in Lexington—included 17,251 Caucasian and 1,649 African American PCa patients.

After adjusting for health insurance status, cancer treatment, cancer stage and PSA level at diagnosis, smoking status, and geographic location, the five- and 10-year cancer-specific mortality risk was 33% and 39% greater, respectively, among African Americans than Caucasians. Antwi's group reported online ahead of print in the American Journal of Men's Health. The authors noted that the causes of the survival disparity are likely multifactorial, and may include differences in behavioral patterns and societal dynamics as well as differences in the standards of medical care received by African Americans and Caucasians.”For example, physicians who treat African Americans tend to have less clinical training and have reported greater difficulties in obtaining access to clinical resources for their patients compared with physicians who treat Caucasians,” the investigators noted,  citing a previous study published in the New England Journal of Medicine (2004;351:575-584).

“Identifying factors that do not contribute to the racial differences in PC [prostate cancer] survival helps clarify direction for future studies in this area of health disparity,” the investigators wrote.

Antwi's group noted that their study was restricted to patients in Kentucky, which limits the generalizeability of study findings. In addition, there is a possibility that the observed association between race and mortality after the diagnosis of PCa could be due to the effects of other unmeasured factors, such as comorbid conditions, socioeconomic status, and adherence to stage-specific treatment guidelines between the two racial groups.

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