Association of healthcare systems with prostate cancer-specific mortality in Black and White men

Black men have higher cancer-specific mortality rates than White men.  Researchers evaluated drivers of disparities in PC in a nationally representative registry and in the VA equal-access health system. 

Men diagnosed with prostate cancer between 2004 and 2015, including 311,691 in SEER and 90,749 in the VA were studied.  Black men were 23% more likely to present with metastatic disease in SEER but only 7% more likely in the VA. Black men also had a higher risk for death from prostate cancer. When the authors adjusted for the extent of disease, PSA level, and Gleason score at the time of diagnosis, the association between race and prostate cancer-specific mortality largely disappeared — only 4% more likely in Black men.  The authors conclude that racial disparities in prostate cancer-specific mortality were present in a nationally representative registry but not in an equal access healthcare system, due to differences in advanced disease at the time of presentation.  Longer follow-up will be needed to fully assess the mortality results.

J Natl Cancer Inst.  2021, PMID 338924