1. Association of Black Race With Prostate Cancer–Specific and Other-Cause Mortality
- Author
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Dess, Robert T, Hartman, Holly E, Mahal, Brandon A, Soni, Payal D, Jackson, William C, Cooperberg, Matthew R, Amling, Christopher L, Aronson, William J, Kane, Christopher J, Terris, Martha K, Zumsteg, Zachary S, Butler, Santino, Osborne, Joseph R, Morgan, Todd M, Mehra, Rohit, Salami, Simpa S, Kishan, Amar U, Wang, Chenyang, Schaeffer, Edward M, Roach, Mack, Pisansky, Thomas M, Shipley, William U, Freedland, Stephen J, Sandler, Howard M, Halabi, Susan, Feng, Felix Y, Dignam, James J, Nguyen, Paul L, Schipper, Matthew J, and Spratt, Daniel E
- Subjects
Prostate Cancer ,Prevention ,Aging ,Clinical Trials and Supportive Activities ,Urologic Diseases ,Clinical Research ,Cancer ,Patient Safety ,Good Health and Well Being ,Black or African American ,Aged ,Cause of Death ,Humans ,Male ,Middle Aged ,Prostatic Neoplasms ,SEER Program ,United States ,United States Department of Veterans Affairs ,Oncology and Carcinogenesis ,Public Health and Health Services - Abstract
ImportanceBlack men are more likely to die of prostate cancer than white men. In men with similar stages of disease, the contribution of biological vs nonbiological differences to this observed disparity is unclear.ObjectiveTo quantify the association of black race with long-term survival outcomes after controlling for known prognostic variables and access to care among men with prostate cancer.Design, setting, and participantsThis multiple-cohort study included updated individual patient-level data of men with clinical T1-4N0-1M0 prostate cancer from the following 3 cohorts: Surveillance, Epidemiology, and End Results (SEER [n = 296 273]); 5 equal-access regional medical centers within the Veterans Affairs health system (VA [n = 3972]); and 4 pooled National Cancer Institute-sponsored Radiation Therapy Oncology Group phase 3 randomized clinical trials (RCTs [n = 5854]). Data were collected in the 3 cohorts from January 1, 1992, through December 31, 2013, and analyzed from April 27, 2017, through April 13, 2019.ExposuresIn the VA and RCT cohorts, all patients received surgery and radiotherapy, respectively, with curative intent. In SEER, radical treatment, hormone therapy, or conservative management were received.Main outcomes and measuresProstate cancer-specific mortality (PCSM). Secondary measures included other-cause mortality (OCM). To adjust for demographic-, cancer-, and treatment-related baseline differences, inverse probability weighting (IPW) was performed.ResultsAmong the 306 100 participants included in the analysis (mean [SD] age, 64.9 [8.9] years), black men constituted 52 840 patients (17.8%) in the SEER cohort, 1513 (38.1%) in the VA cohort, and 1129 (19.3%) in the RCT cohort. Black race was associated with an increased age-adjusted PCSM hazard (subdistribution hazard ratio [sHR], 1.30; 95% CI, 1.23-1.37; P
- Published
- 2019