1. African‐American men and prostate cancer‐specific mortality: a competing risk analysis of a large institutional cohort, 1989–2015
- Author
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Julio M. Pow‐Sang, Jong Y. Park, Vonetta L. Williams, Kosj Yamoah, Travis Gerke, Angelina K. Fink, and Shivanshu Awasthi
- Subjects
Male ,Cancer Research ,Competing risks ,Continuous variable ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,parasitic diseases ,medicine ,African american men ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Healthcare Disparities ,Early Detection of Cancer ,Original Research ,Aged ,prostate cancer‐specific mortality ,Insurance, Health ,business.industry ,competing risk analysis ,Age Factors ,Prostatic Neoplasms ,Specific mortality ,Health Status Disparities ,Middle Aged ,medicine.disease ,prostate cancer ,Prognosis ,Comorbidity ,United States ,Race Factors ,Black or African American ,Increased risk ,African‐American men ,Oncology ,disparity ,030220 oncology & carcinogenesis ,Cohort ,other cause mortality ,business ,Cancer Prevention ,Demography - Abstract
Significant racial disparities in prostate cancer (PCa) outcomes have been reported, with African‐American men (AAM) more likely to endure adverse oncologic outcomes. Despite efforts to dissipate racial disparities in PCa, a survival gap persists and it remains unclear to what extent this disparity can be explained by known clinicodemographic factors. In this study, we leveraged our large institutional database, spanning over 25 years, to investigate whether AAM continued to experience poor PCa outcomes and factors that may contribute to racial disparities in PCa. A total of 7307 patients diagnosed with PCa from 1989 through 2015 were included. Associations of race and clinicodemographic characteristics were analyzed using chi‐square for categorical and Mann–Whitney U‐test for continuous variables. Racial differences in prostate cancer outcomes were analyzed using competing risk analysis methods of Fine and Gray. Median follow‐up time was 106 months. There were 2304 deaths recorded, of which 432 resulted from PCa. AAM were more likely to be diagnosed at an earlier age (median 60 vs. 65 years, P = 60 years), racial differences in PCSM were more pronounced, with AAM experiencing higher rates of PCSM (HR, 2.05, 95% CI, 1.26–3.34, P = 0.003). After adjustment of clinicodemographic and potential risk factors, AAM continue to experience an increased risk of mortality from PCa, especially older AAM. Furthermore, AAM are more likely to be diagnosed at an early age and more likely to have higher comorbidity indices.
- Published
- 2018