Disparities in Prostate Cancer Treatment Modality and Quality of Life

Abstract

Abstract : Prostate cancer is a serious condition that has a substantial societal burden. In 2010, approximately 217,730 new cases of prostate cancer and 32,050 deaths were reported in the US. Between 2002 and 2006 race differences in age-adjusted prostate cancer incidence rates were substantial (155.5 and 25.6 per 100,000, respectively). A similar disparity exists in the age-adjusted prostate cancer death rates within the same period (23.6 deaths per 100,000 males for whites and 56.3 for African American men). Compared to whites, African Americans have higher prostate cancer incidence, are diagnosed at later stages of disease, and have lower five-year survival rates. Additionally, they are less likely to be enrolled in clinical trials and there are indications that supportive services may not be as readily available to them. Although African Americans have a substantially worst profile with regard to prostate cancer, there have been relatively few research investigations of race differences in prostate cancer screening, diagnosis and quality of life. We designed the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes (DAD) Study to explore factors that influence race differences in prostate cancer screening, diagnosis, treatment and quality of life in 877 prostate cancer survivors. We observed that African Americans received fewer sources of information regarding prostate cancer treatment, appeared to be more self reliant in their decision making regarding prostate cancer treatment, and were more reliant on religious faith for coping with prostate cancer than whites. African Americans patients are less well-informed about their decision making related to prostate cancer. This may contribute to the well documented disparities in patient outcomes.