MP64-16 PROSTATE CANCER AND HISPANIC MEN: UNMASKING THE DIVERSITY AND DATA

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP64)1 Apr 2020MP64-16 PROSTATE CANCER AND HISPANIC MEN: UNMASKING THE DIVERSITY AND DATA Gricelda Gomez*, Marieke J. Krimphove, Adam S. Kibel, Luis A. Kluth, Kerry Kilbridge, Thomas Seisen, and Quoc-Dien Trinh Gricelda Gomez*Gricelda Gomez* More articles by this author , Marieke J. KrimphoveMarieke J. Krimphove More articles by this author , Adam S. KibelAdam S. Kibel More articles by this author , Luis A. KluthLuis A. Kluth More articles by this author , Kerry KilbridgeKerry Kilbridge More articles by this author , Thomas SeisenThomas Seisen More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000939.016AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Hispanics in the Unites States (US) have the lowest overall incidence and mortality rates of prostate cancer (PCa) compared to other race/ethnicity groups. However, Hispanics are a heterogeneous group of individuals varying by many factors that affect cancer outcomes. We sought to determine if differences in disease severity at diagnosis, treatment, and mortality exist among US Hispanics based on country of origin. METHODS: Patients (n = 505,820) with localized PCa diagnosed between 2004 and 2015 within the National Cancer Data Base were identified. Hispanic patients were stratified by most populous ethnicities in the US: Mexican, Puerto Rican, a Caribbean group (Cuba and Dominican Republic), Central/South American, and other/unknown Hispanic. The effect of Hispanic supgroup on disease severity, receipt of definitive treatment and overall survival was assessed. Disease severity was based on the D’Amico risk classification. RESULTS: Outcomes for Hispanics as an aggregate group varied greatly to those of the Hispanic subgroups, when compared to Non-Hispanic Whites (NHWs). Hispanics overall had higher risk of presenting with intermediate-risk (relative risk ratio [RRR] 1.09, 95%CI: 1.06-1.13, p<0.001) and high-risk disease (RRR 1.15, 95%CI: 1.10-1.18, p<0.001). In subgroup analysis, Mexicans (RRR= 1.23, 95%CI: 1.12-1.33, p<0.001) and Puerto Ricans (RRR= 1.15, 95%CI: 1.00-1.32, p=0.050) had greater odds of presenting with high-risk PCa, whereas, Caribbean men had lower odds (RRR= 0.88, 95%CI: 0.78-0.99, p=0.032). Hispanics overall have lower risk of mortality relative to NHWs among all three D’amico risk groups. This effect is observed among all subgroups for patients with high-risk PCa. Among patients with low-risk disease, only Central/South Americans (HR= 0.58, 95%CI: 0.38-0.91, p<0.001) had a decreased risk of mortality. CONCLUSIONS: By aggregating the diversity of people within one broad category of Hispanic, important differences within the population are masked. Our study shows differences in the presentation, management and outcome of localized PCa across different Hispanic subgroups. Although Hispanic subgroups present with worse disease at diagnosis compared to NHWs, they fare better in terms of overall survival, underscoring the “Hispanic paradox.” This concept summarizes the fact that US Hispanics live longer and have better health outcomes compared to NHWs, despite having lower socioeconomic status and less health-care access. Our results highlight the need for disaggregation of data, which can help us understand the factors that lead to the “Hispanic Paradox.” Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e969-e969 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gricelda Gomez* More articles by this author Marieke J. Krimphove More articles by this author Adam S. Kibel More articles by this author Luis A. Kluth More articles by this author Kerry Kilbridge More articles by this author Thomas Seisen More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement PDF downloadLoading ...