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Racial treatment trends in localized/regional prostate carcinoma: 1992–1999

  1. Willie Underwood III M.D., M.S., M.P.H.1,2,†,*,
  2. James Jackson Ph.D.3,4,
  3. John T. Wei M.D., M.S.1,
  4. Rodney Dunn M.S.1,
  5. Edmond Baker M.D.5,
  6. Sonya DeMonner M.P.H.6,
  7. David P. Wood M.D.1

Article first published online: 20 DEC 2004

DOI: 10.1002/cncr.20796

Issue

Cancer

Cancer

Volume 103, Issue 3, pages 538–545, 1 February 2005

Additional Information

How to Cite

Underwood, W., Jackson, J., Wei, J. T., Dunn, R., Baker, E., DeMonner, S. and Wood, D. P. (2005), Racial treatment trends in localized/regional prostate carcinoma: 1992–1999. Cancer, 103: 538–545. doi: 10.1002/cncr.20796

Author Information

  1. 1

    Division of Clinical Research and Quality Assurance, Department of Urology, University of Michigan, Ann Arbor, Michigan

  2. 2

    Veterans Administration Center for Practice Management and Outcomes Research, Ann Arbor, Michigan

  3. 3

    Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, Michigan

  4. 4

    Center for African American and African Studies, University of Michigan, Ann Arbor, Michigan

  5. 5

    Department of Surgery, University of Michigan, Ann Arbor, Michigan

  6. 6

    Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan

  1. †

    Fax: (734) 647-3301

*Department of Urology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0330

  1. †

    Fax: (734) 647-3301

Publication History

  1. Issue published online: 20 JAN 2005
  2. Article first published online: 20 DEC 2004
  3. Manuscript Accepted: 6 OCT 2004
  4. Manuscript Revised: 7 SEP 2004
  5. Manuscript Received: 3 JUN 2004

Funded by

  • United States Public Health Service (National Cancer Institute). Grant Number: P50CA69568

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Keywords:

  • African American;
  • Hispanic;
  • white;
  • brachytherapy;
  • radical prostatectomy;
  • external beam radiation therapy;
  • prostate carcinoma;
  • prostate carcinoma treatment;
  • combination therapy

Abstract

BACKGROUND

African-American men have a greater incidence of and mortality from prostate carcinoma compared with white men, and they are less likely to receive definitive therapy (radical prostatectomy or external beam radiation therapy). During the 1990s, the use of brachytherapy increased; however, its influence on racial and ethnic prostate carcinoma treatment trends remains unclear. The objective of this study was to describe treatment trends over the period 1992–1999 for localized/regional prostate carcinoma among white, Hispanic, and African-American men.

METHODS

Using the Surveillance, Epidemiology, and End Results (SEER) registry data from 1992 through 1999, logistic regression models were used to determine whether the odds of receiving a specific treatment modality differed by racial and ethnic group and whether the differences changed over time when the models were adjusted for age, marital status, tumor grade, and SEER site (geography).

RESULTS

The authors identified 142,340 men, including white men (81.6%), Hispanic men (6.4%), and African-American men (12.0%). Racial and ethnic differences in the rates of use of androgen-deprivation therapy/expectant management were noted; however, these differences appeared to lessen over time (P < 0.001). The rate of utilization of radical prostatectomy increased for Hispanic men, remained flat for African-American men, and decreased for white men. The utilization of brachytherapy and combination therapy increased for all three groups; however, the greatest increase in utilization was among white men.

CONCLUSIONS

Further research will be required to determine the patient-level and provider-level variables that influence racial and ethnic treatment differences in localized/regional prostate cancer. Cancer 2005. © 2005 American Cancer Society.

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