Although equal-access health care reduces some disparities, Black men continue to experience higher rates of prostate cancer and metastatic burden compared with White men, a new study finds.
Among 7,889,984 men treated at US Veterans Affairs centers nationwide, Black veterans had a nearly 2-fold higher incidence of localized and de novo metastatic prostate cancer compared with White men after adjusting for age, Kosj Yamoah, MD, PhD, of H. Lee Moffitt Cancer & Research Institute in Tampa, Florida, and colleagues reported in JAMA Network Open. Black men had a significant 29% increased risk of prostate cancer detection upon biopsy.
Response to prostate cancer treatment appeared similar between racial groups. Among 92,269 veterans receiving definitive treatment, Black men had a significant 11% lower risk of metastasis compared with White men, which was likely due to the use of radiation therapy, according to the investigators. The median time to treatment was slightly longer for black men: 125 vs 110 days.
Distant metastasis nonetheless occurred at nearly twice the rate in Black vs White men across National Comprehensive Cancer Network risk groups (low risk, 4 vs 2 per 100,000; intermediate risk, 13 vs 6 per 100,000; and high risk, 19 vs 9 per 100,000).
“Therefore, equitable and timely intervention can translate to improved outcomes, but it may not eliminate the residual disparity owing to incidence observed among African American men who continue to endure higher rates of distant metastasis despite receiving similar treatment, Dr Yamoah’s team wrote. “Therefore, a broader approach is warranted to understand the etiologic factors associated with these racial and ethnic disparities.”
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Yamoah K, Lee KM, Awasthi S, et al. Racial and ethnic disparities in prostate cancer outcomes in the Veterans Affairs health care system. JAMA Netw Open. Published online January 18, 2021. doi:10.1001/jamanetworkopen.2021.44027