Outcomes No Worse for Black Veterans With Prostate Cancer

For men in VA health system, blacks do not present with more advanced disease or have higher mortality

MONDAY, Jan. 27, 2020 (HealthDay News) -- For men diagnosed with prostate cancer in the Veterans Affairs health system, African-Americans (AAs) do not present with more advanced disease or have worse outcomes compared with non-Hispanic whites (NHWs), according to a study published online Jan. 27 in Cancer.

Paul Riviere, from the University of California at San Diego in La Jolla, and colleagues assembled a cohort of 60,035 men (30.3 percent AA and 69.7 percent NHW) from a database of veterans diagnosed with prostate cancer between 2000 and 2015.

The researchers found that AA men were more likely to live in regions with a lower median income and lower high school graduation rates compared with NHW men. AA men were younger and had a higher prostate-specific antigen level at the time of diagnosis, but they were less likely to have Gleason score 8 to 10 disease (18.8 versus 19.7 percent), a clinical T classification ≥3 (2.2 versus 2.9 percent), or distant metastatic disease (2.7 versus 3.1 percent) than NHW men. AA men had a lower 10-year prostate cancer-specific mortality rate (4.4 versus 5.1 percent); this finding was confirmed in a multivariable competing-risk analysis (subdistribution hazard ratio, 0.85).

"These results suggest that poorer outcomes for African-American men with prostate cancer may not be a foregone conclusion," a coauthor said in a statement. "With smart public policy choices, we may be able to reduce or even eliminate disparities and achieve equal outcomes for all men with prostate cancer."

Several authors disclosed financial ties to biopharmaceutical, medical technology, and consulting companies.

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