Reporting racial/ethnic disparities in aggregate obscures within-group heterogeneity. We sought to identify disparities in diagnosis and treatment in Hispanic subpopulations with metastatic prostate cancer (mPCa).
We disaggregated men with prostate adenocarcinoma from the National Cancer Database from 2004 to 2017 by racial subgroup and Hispanic background. We assessed (1) presenting with mPCa, (2) receiving any treatment, and (3) receiving delayed treatment beyond 90 days. Logistic regression and adjusted odds ratios (aOR) were reported.
Hispanic men had greater odds of presenting with mPCa (aOR, 1.54; 95% CI, 1.50 to 1.58; P < .001) compared with non-Hispanic White (NHW) men. All Hispanic racial subgroups were more likely to present with mPCa, with the highest risk in Hispanic Black (HB) men (aOR, 1.68; 95% CI, 1.46 to 1.93; P < .01). Men from all Hispanic backgrounds had higher odds of presenting with mPCa, especially Mexican men (aOR, 1.99; 95% CI, 1.86 to 2.12; P < .01). Hispanic men were less likely to receive any treatment (aOR, 0.60; 95% CI, 0.53 to 0.67; P < .001), and this effect was particularly strong for Hispanic White patients (aOR, 0.58; 95% CI, 0.52 to 0.66; P < .001) and Dominican men (aOR, 0.52; 95% CI, 0.28 to 0.98; P = .044). Hispanic men were more likely to experience treatment delays compared with NHW men (aOR, 1.38; 95% CI, 1.26 to 1.52; P < .001) and in particular HB (aOR, 1.83; 95% CI, 1.22 to 2.75; P = .002) and South/Central American men (aOR, 1.48; 95% CI, 1.07 to 2.04; P = .018).
Differences exist in stage at presentation, treatment receipt, and delays in treatment on disaggregation by racial subgroup and Hispanic heritage. We need to study the potential mechanisms of the observed variations to help develop targeted interventions.
JCO oncology practice. 2023 Jun 01 [Epub ahead of print]
Helen Y Hougen, Nishwant Swami, Edward Christopher Dee, Mohammed Alshalalfa, Karthik Meiyappan, Narjust Florez, Frank J Penedo, Paul L Nguyen, Sanoj Punnen, Brandon A Mahal
Desai Sethi Urology Institute, University of Miami, Miami, FL., University of Massachusetts Chan Medical School, Worcester, MA., Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Sylvester Comprehensive Cancer Center, Miami, FL., University of Miami Miller School of Medicine, Miami, FL., Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA., Departments of Psychology and Medicine, University of Miami Miller School of Medicine and College of Arts and Sciences, Miami, FL., Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA.