Among Hispanic-American (HA) men, prostatic cancer (PCa) accounts for nearly one-quarter of the total cancer burden. We sought to identify differences in PCa presentation and treatment status for HA subgroups based on country/region of origin.
Using the National Cancer Database, we identified patients with histologically confirmed prostate adenocarcinoma with reported race/ethnicity, clinical staging, Gleason score ≥ 6, and PSA level at diagnosis from 2010 to 2016. HAs were divided into 4 subgroups: Mexican, Puerto Ricans, Cubans, and Central/South Americans. Non-Hispanic White (NHW) men were used as a reference group. Statistical analysis was derived from the Kruskal-Wallis test for continuous variables and χ2 test for categorical variables. Models were constructed to evaluate the association of Hispanic country of origin with metastatic presentation and treatment status.
A total of 428,829 patients were included, with 5625 (1.3%) classified as HA. Within the Hispanic group, 2880 (51.2%) were Mexican, 999 (17.8%) Puerto Rican, 477 (8.5%) Cuban, and 1269 (22.6%) South/Central American. Mexican men presented with higher median PSA, more Gleason 8 to 10 disease, and higher rates of metastatic presentation compared to NHW and other HA subgroups (all, p < .01). Metastatic rates over the study period for Mexican, Puerto Rican, Cuban, and South/Central Americans were 6.4 (±1.2), 5.3 (±3.0), 3.2 (±2.0), and 4.6% (±1.7), respectively (p = .01). Treatment rates were 89.1, 89.6, 92.4, and 89.3% for Mexican, Puerto Rican, Cuban, and South/Central Americans, respectively (p = .19). Mexican men had higher odds of initial metastatic presentation (OR: 1.32; 95%CI: 1.07-1.63, p = .01) but lower odds of receiving treatment (0.68; 0.55-0.85, p < .01).
Men of Mexican origin presented with more advanced PCa when compared to NHW and other Hispanic subgroups. Our results warrant further investigation into potential biological factors affecting Hispanic patients as well as the identification of treatment barriers for this vulnerable population.
Clinical genitourinary cancer. 2023 Oct 06 [Epub ahead of print]
Ricardo J Estrada-Mendizabal, Armaan Singh Dhaliwal, Aaron J Bertolo, Ken Batai, Ronald Heimark, Alejandro Recio-Boiles, Juan Chipollini
School of Medicine and Health Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico., Department of Medicine, University of Arizona, AZ., Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY., Department of Surgery, University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ., Department of Medicine, University of Arizona, AZ; University of Arizona Cancer Center, Tucson, AZ., Department of Urology, University of Arizona, Tucson, AZ. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37903669