Black patients treated with radical prostatectomy for localized prostate cancer (PCa) are more likely to experience adverse events and incur higher costs than non-Hispanic white patients, a new study published online ahead of print in JAMA Oncology has shown. Fortunately, these negative effects do not translate to a disparity in cancer-specific or all-cause mortality.
Because there has been much data suggesting that black men with localized prostate cancer have a higher rate of cancer-specific mortality compared with white patients, researchers sought to assess racial disparities in the use, quality of care, and outcomes of radical prostatectomy in elderly men with localized prostate cancer.
For the retrospective analysis, researchers analyzed data from 2,020 black patients and 24,462 white patients age 65 years or older with localized prostate cancer who underwent radical prostatectomy within the first year of diagnosis between 1992 and 2009 from the SEER-Medicare database.
Results showed that black patients experienced a 7-day treatment delay compared with non-Hispanic white patients, had a higher risk of postoperative emergency department visits and readmissions both within 30 days of surgery and after 30 days or more, and incurred higher incremental annual costs.
However, there was no difference in prostate cancer-specific mortality or all-cause mortality between the 2 patient populations.
“Because the unfavorable quality of care did not translate into worse overall and cancer-specific survival in our sample, the commonly perceived detrimental survival in black patients with PCa may be the sequelae of barriers and selection bias in definitive treatment,” the authors conclude. “Public and professional awareness needs to be raised to address these concerning issues and identify their underlying causes.”
- Schmid M, Meyer CP, Reznor G, et al. Racial differences in the surgical care of Medicare beneficiaries with localized prostate cancer [published online ahead of print October 22, 2015]. JAMA Oncol. doi:10.1001/jamaoncol.2015.3384.