MP81-05 RACIAL DISPARITIES DIFFER FOR AFRICAN AMERICANS AND HISPANICS IN THE DIAGNOSIS AND TREATMENT OF PENILE CANCER

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease II1 Apr 2016MP81-05 RACIAL DISPARITIES DIFFER FOR AFRICAN AMERICANS AND HISPANICS IN THE DIAGNOSIS AND TREATMENT OF PENILE CANCER Emily Slopnick, Simon Kim, Jonathan Kiechle, Chris Gonzalez, Hui Zhu, and Robert Abouassaly Emily SlopnickEmily Slopnick More articles by this author , Simon KimSimon Kim More articles by this author , Jonathan KiechleJonathan Kiechle More articles by this author , Chris GonzalezChris Gonzalez More articles by this author , Hui ZhuHui Zhu More articles by this author , and Robert AbouassalyRobert Abouassaly More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2058AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Non-Caucasian race is often associated with adverse stage and prognosis for urologic malignancies. African-American (AA) men have worse survival and are at risk to receive suboptimal care in prostate cancer. For penile cancer, prior studies suggest that AA and Hispanic men present with more advanced disease and higher incidence, respectively. Little is known about racial differences in surgical management. We sought to determine racial variation as compared to white men in the diagnosis and treatment of penile cancer. METHODS Using the 1998 - 2012 National Cancer Data Base for penile cancer, men with squamous cell carcinoma (SCC) were stratified by race and ethnicity. Demographic and disease characteristics were compared between groups. Likelihood of undergoing surgical treatment, type of surgery, and mortality were also compared. Factors influencing disease stage at diagnosis and treatment choice were analyzed with univariate and multivariable logistic regressions. Overall survival, stratified by race, was examined with Kaplan Meier and adjusted Cox proportional hazard models. RESULTS We identified 12,090 men with penile SCC with median age 66 years (range 18-90). 76.8% of men are Caucasian, 10.2% AA, and 8.7% Hispanic. At diagnosis, Hispanic men are younger and less likely to have insurance than other groups (p<0.001). On multivariable logistic regression, Hispanic men are more likely to present with AJCC pathologic stage II than stage I SCC compared to Caucasian patients (OR 1.6; CI 1.20-2.00; p=0.001). AA men are less likely to undergo surgery of any type (OR 0.69; CI 0.54-0.89; p=0.004) and more likely to have partial rather than total penectomy (OR 0.64; CI 0.48-0.84; p=0.002) for equal stage SCC on multivariable analysis. Moreover, AA men have higher mortality rates than other groups (HR 1.25; CI 1.10-1.42; p<0.001). CONCLUSIONS While Hispanic men have higher stage disease at diagnosis with penile SCC, they are treated equally to Caucasian patients with comparable survival. AA men, however, undergo less aggressive surgical treatment and have higher mortality rates as compared to other racial or ethnic groups. The differences identified in our study allow race-appropriate targeting of interventions aimed at improving the prognosis of this malignancy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1054 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Emily Slopnick More articles by this author Simon Kim More articles by this author Jonathan Kiechle More articles by this author Chris Gonzalez More articles by this author Hui Zhu More articles by this author Robert Abouassaly More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...