Prostate cancer disparities in clinical and survival patterns among Black and Latino patients considering nativity: findings from the California Cancer Registry.

Abstract

We investigated clinical characteristics and prostate cancer (PCa) survival patterns among Latino patients considering nativity compared to non-Latino Black (NLB) and non-Latino White (NLW) patients. We used data from the California Cancer Registry (1995-2021), which included 347,540 NLW, 50,032 NLB, and 75,238 Latino PCa patients. Frequencies of sociodemographic and clinical variables were assessed with Chi-square tests. Multivariable regression models were fitted to evaluate determinants of treatment reception, Gleason upgrade, and survival differences. Exploratory analyses were conducted grouping Latino cases into US-born and non-US-born by country-of-origin. Compared to NLW, NLB cases had the greatest proportion of younger patients, whereas non-US-born Latino patients had the greatest proportion of low socio-economic status and uninsured patients. Non-US-born Latinos showed greater proportion of diagnoses completed with <6 core biopsies, Gleason >8, stage IV tumors and metastasis. Multivariable analyses showed that compared to NLW, Latino patients were as likely to receive treatment, whereas NLB cases were less likely (OR = 0.81, 95% CI: 0.67-0.98, p = 0.029). Compared to NLW, Non-US-born Latino cases were less likely to die of PCa (HR = 0.78; 95% CI = 0.64-0.94, p=0.011), with no difference reported for NLB cases. Considering sociodemographic and clinical characteristics, non-US-born Latino PCa patients had better survival than NLW. This highlights the need to identify key determinants of these survival differences, and the importance of sociodemographic and clinical determinants in survival disparities. Our study emphasizes the importance of considering nativity among Latino patients to understand PCa disparities and outcomes in this population.