Epidemiology and regional variation in the mortality of patients admitted with prostate cancer in the United States.

Abstract

69 Background: Prostate cancer is one of the most common cancers in men and one of the leading causes of death among men of all races worldwide. Prostate cancer prevalence and mortality vary substantially by race, ethnicity and geography. The reason behind the disparity is unclear, however, access to screening and treatment, variation in exposure to risk factors, genetic susceptibility, lifestyle practices are the suggested factors that affect the disparity. Methods: We conducted a retrospective analysis of the National Inpatient Sample Database for the year 2016. Patients who were admitted with a principal diagnosis of Malignant Neoplasm of Prostate (MNP) were identified using ICD-10 codes. The epidemiology, racial disparities and regional variations in the mortality of prostate cancer, trend in the cost and length of stay were studied. Results: A total of 39,853 hospitalizations were identified with a principal diagnosis of MNP. The prevalence of MNP was found to be 0.56% with mean age of diagnosis 71.36 ± 0.55. The prevalence of prostate cancer was found to be highest in African Americans (0.65%), followed by Caucasians (0.60%). The disease-specific mortality rate for MNP was 3.45% (n=1,375). African Americans (AA) had 32% more risk of dying with prostate cancer when compared to all the other groups (OR= 1.322, P= 0.001, 95% CI= 1.14-1.52). Caucasians had 25% less chance of dying and Hispanic had 28% less chance of dying with prostate cancer when compared to AA (OR= 0.755, P= 0.001, CI= 0.65-0.87 vs OR= 0.72, P= 0.016, CI= 0.56- 0.94). Those who admitted to West were 22% more likely to die and those admitted to Northeast were 18% more likely to die when compared to Midwest and south regions (OR= 1.22, P= 0.037, CI= 1.01- 1.47 vs OR= 1.18, P= 0.062, CI= 0.91-1.4). The length of stay and also cost of stay were found to be highest for African American population. Conclusions: The prevalence, mortality of prostate cancer, cost and length of inpatient stay were highest among African Americans. There was a statistically significant difference in the mortality rate of prostate cancer based on the hospital regions in the United States. More studies are needed to better understand the reasons behind the regional difference.