Abstract A108: Racial/ethnic disparities in prostate cancer treatment persist

Abstract

Abstract Background: Adjusting for stage and grade, Black and Hispanic men have lower prostate cancer (PCa) survival than White men. These survival differences are most likely multifactorial, but they have, in part, been attributed to lower receipt of definitive treatment (prostatectomy or radiation therapy vs. active surveillance or hormone therapy alone). Disparities in receipt of definitive treatment have been well documented in older SEER cohorts; however, we do not know if they persist. Therefore, we used the Surveillance Epidemiology End Result (SEER) Tumor Registry to analyze patterns of PCa treatment by race/ethnicity (Black, Hispanic, Asian/Other, and White men) in men diagnosed with clinically localized PCa between 2004–2007. Method: Logistic regression was performed to determine whether there were racial/ethnic differences in the odds of receiving definitive treatment, adjusting for age, year of diagnosis, grade, PSA, National Comprehensive Cancer Network (NCCN) risk, SEER site, and marital status. We then examined the relative adjusted odds of receiving definitive treatment at each level of NCCN risk for Black, Hispanic and Asian/other men compared to White men. Results: Data from 175,366 (White 130,096, Black 21,503, Hispanic 14,412, and Asian/other 9,355) men were included in the analyses. In the overall sample, Black men (OR=0.72, 95% CI=0.69-0.75) and Hispanic men (OR=0.92, 95% CI=0.88-0.96) had lower odds of receiving definitive therapy compared to White men. For Black men, this remained true at every level of risk, even among men with high (OR=0.62, 95%CI=0/55-0.69) and very high risk prostate cancer (OR=0.73, 95%CI=0.67-0.80). Hispanic men with high risk disease had lower odds of receiving definitive treatment than their White counterparts (OR=.80, 95%CI=.70-.90). However, the gap was not significant among Hispanics and Whites with the highest risk disease (OR=1.0, 95%CI=0.90-1.11). For Asian/other men, the odds of receiving definitive treatment were not significantly different than for White men, either overall or when stratified by NCCN risk. Racial/ethnic differences in the receipt of definitive treatment persist even among men with high risk disease. In order to address PCa treatment disparities and impact racial/ethnic disparities in PCa survival, further investigation of PCa treatment decision making is warranted. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A108.