Racial/Ethnic Disparities in Tumor Characteristics and Treatments in Favorable and Unfavorable Intermediate Risk Prostate Cancer
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Racial/Ethnic Disparities in Tumor Characteristics and Treatments in Favorable and Unfavorable Intermediate Risk Prostate Cancer. / Wenzel, Mike; Nocera, Luigi; Collà Ruvolo, Claudia; Würnschimmel, Christoph; Tian, Zhe; Shariat, Shahrokh F; Saad, Fred; Briganti, Alberto; Tilki, Derya; Graefen, Markus; Kluth, Luis A; Mandel, Philipp; Chun, Felix K H; Karakiewicz, Pierre I.
In: J UROLOGY, Vol. 206, No. 1, 07.2021, p. 69-79.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Racial/Ethnic Disparities in Tumor Characteristics and Treatments in Favorable and Unfavorable Intermediate Risk Prostate Cancer
AU - Wenzel, Mike
AU - Nocera, Luigi
AU - Collà Ruvolo, Claudia
AU - Würnschimmel, Christoph
AU - Tian, Zhe
AU - Shariat, Shahrokh F
AU - Saad, Fred
AU - Briganti, Alberto
AU - Tilki, Derya
AU - Graefen, Markus
AU - Kluth, Luis A
AU - Mandel, Philipp
AU - Chun, Felix K H
AU - Karakiewicz, Pierre I
PY - 2021/7
Y1 - 2021/7
N2 - PURPOSE: We hypothesized that differences in active treatment rates may exist according to race/ethnicity in favorable as well as unfavorable intermediate risk prostate cancer.MATERIALS AND METHODS: We relied on the Surveillance, Epidemiology, and End Results 18 database 2010-2015. We stratified according to 3 racial/ethnic groups (White vs Black vs Hispanic) and prostate cancer baseline characteristics (prostate specific antigen, clinical T stage, Gleason group grading, percentage of biopsy cores). We tabulated active treatment rates (radical prostatectomy, external beam radiotherapy) without and with adjustment for baseline age and prostate cancer characteristics.RESULTS: Baseline prostate specific antigen, clinical T stage, Gleason grade and percentage of positive biopsy cores differed according to racial/ethnic groups in both favorable and unfavorable intermediate risk prostate cancer patients (all p <0.05). Similarly, radical prostatectomy and external beam radiotherapy rates differed according to race/ethnicity in both favorable and unfavorable intermediate risk prostate cancer patients. Radical prostatectomy and external beam radiotherapy rates respectively ranged from 31.7%-41.8% and 26.3%-31.0% in favorable intermediate risk cases and from 33.4%-43.9% and 30.9%-35.5% in unfavorable intermediate risk prostate cancer, across the 3 race/ethnicity groups (both p <0.05). The above heterogeneity in active treatment rates disappeared and marginal differences remained after adjustment for baseline age and prostate cancer characteristics.CONCLUSIONS: Interpretation of active treatment rates in favorable and unfavorable intermediate risk prostate cancer may be severely biased, unless detailed and systematic consideration or adjustment for baseline age and prostate cancer characteristic is enforced.
AB - PURPOSE: We hypothesized that differences in active treatment rates may exist according to race/ethnicity in favorable as well as unfavorable intermediate risk prostate cancer.MATERIALS AND METHODS: We relied on the Surveillance, Epidemiology, and End Results 18 database 2010-2015. We stratified according to 3 racial/ethnic groups (White vs Black vs Hispanic) and prostate cancer baseline characteristics (prostate specific antigen, clinical T stage, Gleason group grading, percentage of biopsy cores). We tabulated active treatment rates (radical prostatectomy, external beam radiotherapy) without and with adjustment for baseline age and prostate cancer characteristics.RESULTS: Baseline prostate specific antigen, clinical T stage, Gleason grade and percentage of positive biopsy cores differed according to racial/ethnic groups in both favorable and unfavorable intermediate risk prostate cancer patients (all p <0.05). Similarly, radical prostatectomy and external beam radiotherapy rates differed according to race/ethnicity in both favorable and unfavorable intermediate risk prostate cancer patients. Radical prostatectomy and external beam radiotherapy rates respectively ranged from 31.7%-41.8% and 26.3%-31.0% in favorable intermediate risk cases and from 33.4%-43.9% and 30.9%-35.5% in unfavorable intermediate risk prostate cancer, across the 3 race/ethnicity groups (both p <0.05). The above heterogeneity in active treatment rates disappeared and marginal differences remained after adjustment for baseline age and prostate cancer characteristics.CONCLUSIONS: Interpretation of active treatment rates in favorable and unfavorable intermediate risk prostate cancer may be severely biased, unless detailed and systematic consideration or adjustment for baseline age and prostate cancer characteristic is enforced.
KW - African Americans/statistics & numerical data
KW - Aged
KW - Healthcare Disparities/statistics & numerical data
KW - Hispanic or Latino/statistics & numerical data
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasm Grading
KW - Neoplasm Staging
KW - Prostate-Specific Antigen/blood
KW - Prostatic Neoplasms/blood
KW - Retrospective Studies
KW - Risk Assessment
KW - Whites/statistics & numerical data
U2 - 10.1097/JU.0000000000001695
DO - 10.1097/JU.0000000000001695
M3 - SCORING: Journal article
C2 - 33683934
VL - 206
SP - 69
EP - 79
JO - J UROLOGY
JF - J UROLOGY
SN - 0022-5347
IS - 1
ER -