Access to health care is an important determinant of racial equity in oncologic outcomes among men with prostate cancer (PCa), new findings suggest.
Investigators who studied 60,035 men diagnosed with PCa from 2000 to 2015 and received care in the equal-access Veterans Affairs health system (18,201 black men and 41,834 non-Hispanic white [NHW] men) found that, in contrast to national trends, black men do not appear to present with more advanced disease or experience worse outcomes than NHW men.
In fact, compared with NHW men, black men were significantly less likely to have Gleason score 8 to 10 disease (18.8% vs 19.7%), a clinical T classification 3 or higher (2.2% vs 2.9%), or distant metastasis (2.7% vs 3.1%), a team led by Brent S. Rose, MD, of the University of California at San Diego, reported in Cancer. The 10-year cancer-specific mortality rate was slightly but significantly lower for blacks (4.4% vs 5.1%).
The authors noted that these favorable outcomes for black men were observed even though black men lived in areas with lower socioeconomic status.
Potential differences in biology that affect the frequency and age of onset of PCa likely remain, but the new findings do not support a hypothesis that PCa is inherently more aggressive in black men, the investigators stated. “Rather, the results herein have suggested that access to high-quality medical care is a major determinant of racial equity among men diagnosed with [PCa].”
The median follow-up duration was 5.79 years for black men and 5.89 years for NHW men, and 8967 men were followed for at least 10 years.
Riviere P, Luterstein E, Kumar A, et al. Survival of African American and non-Hispanic white men with prostate cancer in an equal-access health care system [published online January 27, 2020]. Cancer. doi: 10.1002/cncr.32666