Prostate Cancer Disparities in Hispanics Using the National Cancer Database

Abstract

ObjectivesTo evaluate the differences in prostate cancer characteristics and treatment between Hispanic Americans with different countries of origin using the National Cancer Database. MethodsWe performed a retrospective analysis of 54,947 adult Hispanic Americans diagnosed with prostate cancer between 2004 and 2015. Origin was Mexican (N = 7844; 14.3%), South/Central American (N = 4010; 7.3%), Puerto Rican (N = 2938; 5.4%), Cuban (N = 2549; 4.6%), Dominican (N = 1535; 2.8%), Hispanic not specified (N = 36,269; 65.7%). Comparison between characteristics among Hispanic American sub-groups’ categories was performed using chi-square and Kruskal-Wallis tests for categorical and continuous variables respectively. ResultsMexicans had overall worse disease at presentation including highest median PSA (7.8 ng/mL), most prevalent T3/T4 stage (6.7%), M1 stage (8.9%), and high-grade Gleason scores (24.0%) when compared to all other Hispanic American groups. Cubans were most likely to receive hormone therapy and radiation therapy and least likely to receive surgical treatment. Compared to Mexicans, Cubans (hazards ratio [HR] = 1.30, 95% confidence interval = [1.16-1.44]) had worse overall survival, while Puerto Ricans (HR = 1.08 [0.95-1.19] had similar overall survival, and Dominicans (HR = 0.63 [0 0.53-0.75]), South/Central Americans (HR = 0.75, [0.66-0.84]) and not specified (HR = 0.84 [0.79-0.91]) had better survival. ConclusionAmong Hispanic Americans with different countries of origin, disparities in prostate cancer characteristics, treatment choice, and survival do exist. Mexicans had the least favorable prostate cancer characteristics at presentation. Cubans had the worst overall survival while they were also most likely to receive hormone and/or radiation as first-line treatment. Our analysis demonstrates significant heterogeneity in the Hispanic American population.