PD03-02 RACIAL DISPARITIES IN PROSTATE CANCER TREATMENT IN A MULTI-INSTITUTIONAL REGIONAL COLLABORATIVE

Abstract

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making I (PD03)1 Sep 2021PD03-02 RACIAL DISPARITIES IN PROSTATE CANCER TREATMENT IN A MULTI-INSTITUTIONAL REGIONAL COLLABORATIVE Adrien Bernstein, Ruchika Talwar, Elizabeth Handorf, Kaynaat Syed, John Danella, Serge Ginzburg, Laurence Belkoff, Adam Reese, Jeffery Tomaszewski, Eric Singer, Edouard Trabulsi, Bruce Jacobs, Jay Raman, Alex Kutikov, Thomas Guzzo, Robert Uzzo, Marc Smaldone, and Andres Correa Adrien BernsteinAdrien Bernstein More articles by this author , Ruchika TalwarRuchika Talwar More articles by this author , Elizabeth HandorfElizabeth Handorf More articles by this author , Kaynaat SyedKaynaat Syed More articles by this author , John DanellaJohn Danella More articles by this author , Serge GinzburgSerge Ginzburg More articles by this author , Laurence BelkoffLaurence Belkoff More articles by this author , Adam ReeseAdam Reese More articles by this author , Jeffery TomaszewskiJeffery Tomaszewski More articles by this author , Eric SingerEric Singer More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Bruce JacobsBruce Jacobs More articles by this author , Jay RamanJay Raman More articles by this author , Alex KutikovAlex Kutikov More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , and Andres CorreaAndres Correa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001967.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minority communities disproportionately shouldered poor COVID-19 outcomes, however the impact of the pandemic on prostate cancer (PCa) surgery is unknown. To that end, we sought to determine the racial impact on PCa care during the first wave of the pandemic. METHODS: Using a multi-institutional collaborative we evaluated practice patterns for Black and White patients with untreated non-metastatic PCa during the initial COVID-19 lockdown (March-May 2020) compared to prior (March-May 2019). Patient and practice characteristics were compared by race using Fisher’s exact and Pearson’s chi-square to compare categorical variables and Wilcoxon rank sum to evaluate continuous covariates. We determined the covariate-adjusted impact of year and race on surgery, using logistic regression models with a race*year interaction term. RESULTS: Among the 647 men with non-metastatic PCa, 269 received care during the pandemic and 378 prior. Surgery was significantly less likely in Black men (1.3% v 25.9%; p<0.001), despite similar COVID-19 risk factors, biopsy Gleason grade group, and comparable surgery rates prior (17.7% vs. 19.1%; p=0.75). Black men had higher PSA (8.8 vs. 7.2 p=0.04) and were younger (38.2% vs. 24.4% <60 yr; p=0.09). Regression results demonstrated an 94% reduced odds of surgery (OR=0.06, 95% CI 0.007-0.43; p=0.006) for Black patients, with no change for White patients (OR=1.41, 95% CI 0.89-2.21; p=0.142), after adjusting for covariates. Changes in surgical volume varied by site (33% increase to complete shutdown), with sites that experienced the largest reduction in cancer surgery, caring for a greater proportion of Black patients (figure). CONCLUSIONS: In a large multi-institutional regional collaborative, odds of prostatectomy declined only among Black patients during the initial wave of the COVID-19 pandemic. While localized prostate cancer does not require immediate treatment, this study illuminates systemic inequities within healthcare. Public health efforts are needed to fully recognize the unintended consequence of diversion of cancer resources to the pandemic in order to develop balanced mitigation strategies as viral rates continue to fluctuate. Source of Funding: PURC is funded by the Health Care Improvement Foundation through practice participation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e43-e43 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adrien Bernstein More articles by this author Ruchika Talwar More articles by this author Elizabeth Handorf More articles by this author Kaynaat Syed More articles by this author John Danella More articles by this author Serge Ginzburg More articles by this author Laurence Belkoff More articles by this author Adam Reese More articles by this author Jeffery Tomaszewski More articles by this author Eric Singer More articles by this author Edouard Trabulsi More articles by this author Bruce Jacobs More articles by this author Jay Raman More articles by this author Alex Kutikov More articles by this author Thomas Guzzo More articles by this author Robert Uzzo More articles by this author Marc Smaldone More articles by this author Andres Correa More articles by this author Expand All Advertisement Loading ...