Black men’s prostate cancer survival partially dependent on racial differences in definitive therapy

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Researchers, using the National Cancer Data Base, found at most U.S. medical facilities, white men are more likely than black men to receive definitive therapy (surgery and/or radiotherapy) for intermediate- or high-risk prostate cancer (PCa).  Prostate cancer is the second leading cause of cancer-related mortality among men living in the U.S. and it is well-established that PCa incidence and overall outcomes are worse for black men.

“This should not be happening in this day and age across the country,” exclaimed Dr. David Samadi.  “We know that black men with prostate cancer often already have an advanced case at the time of diagnosis with it being a higher-grade and higher-stage than white men. Some explanations for this disparity between white and black men can be attributed to sociodemographic factors, cultural beliefs and genetics.  But this study is showing most hospital facilities tend to favor definitive therapy for white men.”

The goal of this study was to examine variation in the utilization of definitive therapy for the treatment of localized PCa among white and black men with the focus being exclusively on intermediate- and high-risk disease in order to exclude men whom did not require or need definitive therapy. 

Identified from the National Cancer Data Base were 223,873 white men and 59,262 black men aged 40 years or older receiving care at a U.S. facility for biopsy confirmed localized intermediate- or high-risk PCa from January 2004 to December 2013.  During the study period, 83% of white men received definitive therapy compared to 74% of black men. 

“One disturbing trend found was that of facilities reviewed in the report, 39% showed significantly higher rates of definitive therapy for white men compared to only 1% for black men,” state Dr. Samadi.  “This was even after adjusting for sociodemographic and clinical factors.  These findings could be one explanation for why black men have a lower survival rate for prostate cancer than white men.”

The study did have other suggestions for the discrepancies between white and black men in regards to racial variation for consistently higher rates of definitive therapy for men who are white.  Past studies have shown that white men are more likely to have a healthcare provide whom they trust and to have undergone regular PCa screenings.  Black men are less likely to perceive themselves at an increased risk for PCa which could be one reason why they have a higher risk/metastatic disease at the time of diagnosis. 

“This study brings up the fact that despite improvements in prostate cancer survival rates in recent years, black men still remain at a higher risk mainly because they are at a more advanced stage of the disease at diagnosis,” said Dr. Samadi.  “This means more effort and work is required to close the gap of racial disparities among white and black men diagnosed with prostate cancer.  I want all men of color to have equal access of care for their health.  This is where more involvement at the state and national levels including physicians like myself need to be active in reducing these disparities through education, access, and financial help.  It won’t happen overnight, but the sooner we start, the sooner we end the chasm.” 

Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.