Abstract
Abstract Prostate cancer exhibits marked geographic variation with regard to incidence, tumor characteristics, disease progression, and mortality at the local, national, and international level. Within the United States, African American men are approximately twice as likely as white men to die from the disease. It is hypothesized that racial variations in post-diagnosis treatment contribute in part to this disparity. The purpose of this study is to investigate the independent effect of race on the probability of recurrent prostate cancer among patients receiving definitive therapy (surgery or radiation) while adjusting for patient- and area- level characteristics. Incident prostate cancer cases among African American and white men that received definitive therapy within 6 months of diagnosis and were reported to the SEER-Medicare linked database between 1995 and 2002 were identified. Spatial patterning in receipt of definitive therapy treatment by race was mapped using GIS and statistically evaluated using Moran's I global index of spatial autocorrelation. A series of hierarchical logistic regression models with county level random effects were used to characterize the relationship between race and the probability of receipt of post-treatment PSA screening and recurrent prostate cancer. African American men were slightly less likely than white men to receive post-treatment surveillance (OR= 0.99,95% CI= 0.88,1.78) and to be diagnosed with recurrent prostate cancer (OR= 0.98,95% CI= 0.86,1.12), although the difference was not statistically significant. Our findings might underestimate receipt of post-treatment PSA surveillance due to limitations inherent in the use of SEER-Medicare data. Researchers should continue to investigate the implications of access to care and healthcare utilization by various populations and their effect on prostate health. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B81.
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