Prostate cancer: worse inhospital outcomes in US blacks vs whites

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Takeaway
  • Even after matching for demographic, clinical or treatment characteristics, length of stay (LoS), and inhospital mortality was higher in US black men with prostate cancer (PCa) than their white counterparts.

Why this matters

  • Racial disparities persist even after confounding for healthcare access.

Key results

  • 28.47% of blacks had private insurance compared with 32.24% of shites. 
  • 6.9% and 1.4%, respectively, were on Medicaid. 
  • Blacks were more likely to be admitted with metastatic disease (24.8%) compared with demographics- (17.9%), and presentation-matched (23.6%) whites. 
  • 23.9% vs 38.2% and 34.2%, respectively, received surgery.
  • Whites had lower odds of postoperative complications when matched on demographics, presentation and treatment (OR, 0.88; P=.1595). 
  • Whites had shorter LoS when matched on demographics, presentation and treatment (4.29 vs 5.11 d; P<.0001). 
  • Whites had significantly lower inhospital mortality when matched on demographics (OR, 0.72; P<.0001), or demographics and presentation (OR, 0.88; P=.0039), but not when matched on demographics, presentation and treatment (OR, 0.92; P=.0542).

Study design

  • Matched analysis of 183,856 men aged ≥40 y with PCa hospitalized between 2007 and 2011. 
  • Funding: None.

Limitations

  • Lack of data on clinical stage. 
  • Unable to examine time to treatment and survival time.