- In newly diagnosed patients with prostate cancer, the difference in mortality risk by race was observed in population-based study, but not in the equal-access health care system.
- In randomized clinical trials (RCTs), black patients had a lower mortality risk.
Why this matters
- Findings suggest socioeconomic factors influence mortality differences in black patients rather than biological differences.
- Study of individual patient-level data of 306,100 patients with newly diagnosed nonmetastatic prostate cancer from Surveillance, Epidemiology, and End Results (SEER), Veterans Affairs health system (VA), and 4 National Cancer Institute-sponsored phase 3 RCTs.
- Inverse probability weighting was performed to adjust for imbalances by races.
- Funding: Prostate Cancer Foundation.
- Median follow-up, 75-104 months.
- 17.8%-38.1% of the patients were black.
- Black men in the SEER database had lower socioeconomic status, non-Medicaid insurance rate, curative treatment.
- Black patients had a significantly higher risk for:
- SEER cohort: cancer-specific, other cause, and all-cause mortality (subdistribution HR [sHR], 1.09, 1.30, 1.26, respectively; all P<.001>
- RCT cohort: other-cause mortality (sHR, 1.17; P=.002).
- Retrospective design.