MP44-12 CONTEMPORARY CHARACTERIZATION OF PROSTATE CANCER DISPARITIES IN AFRICAN AMERICAN MEN (2019)

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making III (MP44)1 Apr 2019MP44-12 CONTEMPORARY CHARACTERIZATION OF PROSTATE CANCER DISPARITIES IN AFRICAN AMERICAN MEN Adam Reese*, Bret Marlowe, Claudette Fonshell, John Danella, Serge Ginzburg, Thomas Guzzo, Thomas Lanchoney, Jay Raman, Jeffrey Tomaszewski, Edouard Trabulsi, Marc Smaldone, and Robert Uzzo Adam Reese*Adam Reese* More articles by this author , Bret MarloweBret Marlowe More articles by this author , Claudette FonshellClaudette Fonshell More articles by this author , John DanellaJohn Danella More articles by this author , Serge GinzburgSerge Ginzburg More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Thomas LanchoneyThomas Lanchoney More articles by this author , Jay RamanJay Raman More articles by this author , Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , and Robert UzzoRobert Uzzo More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556255.95011.66AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Although the literature has shown clear disparities in prostate cancer incidence and mortality between Caucasian (Cau) and African American (AA) men, the specific factors that lead to adverse outcomes in AA men are less well characterized. We analyzed a regional prostate cancer collaborative to describe contemporary differences in disease-specific variables between Cau and AA men. METHODS: We analyzed the Pennsylvania Urologic Regional Collaborative (PURC), a voluntary collaborative of urology practices in Pennsylvania and New Jersey. For men undergoing initial prostate biopsy, we compared biopsy outcomes between Cau and AA men. For men with a new diagnosis of prostate cancer, we compared clinicopathologic variables and management strategies by race. RESULTS: Of 6049 men who underwent prostate biopsy, 4618 (76.3%) were Cau and 1431 (23.7%) AA. AA men were younger at the time of biopsy, had higher PSA, and were more often diagnosed with prostate cancer and high-grade tumors (Table 1). Among 4034 men diagnosed with prostate cancer, 3034 (75.2%) were Cau and 1000 (24.8%) AA (Table 2). AAs were younger at diagnosis, but were more likely to be diagnosed with metastatic disease. The distribution of Gleason grade group did not differ by race, but AA men had higher volume disease on biopsy. AA men were less likely to undergo radical prostatectomy (RP). Of men treated with RP, pathologic outcomes did not differ significantly by race, with the exception of surgical margins, which were more often positive in AA men. CONCLUSIONS: AA men in the Philadelphia region are diagnosed with prostate cancer at a younger age, and more often have metastatic disease at diagnosis. For those with clinically localized disease, the primary difference between races was in disease volume, not tumor grade. Although AA men were less likely to undergo RP, those who were treated surgically had similar pathologic outcomes to Caucasians. This suggests that AA men with high-risk disease may preferentially undergo radiation as opposed to RP, which may have implications on long-term cancer specific survival. Source of Funding: Data was provided with permission from the Pennsylvania Urologic Regional Collaborative (PURC), funded by participating urology practices and the Partnership for Patient Care, a quality improvement initiative supported by the Health Care Improvement Foundation, Independence Blue Cross, and Southeastern PA hospitals and health systems. Philadelphia, PA; Danville, PA; Philaldelphia, PA; Philadelphia, PA; Bryn Mawr, PA; Hershey, PA; Camden, NJ; Philadelphia, PA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e633-e633 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adam Reese* More articles by this author Bret Marlowe More articles by this author Claudette Fonshell More articles by this author John Danella More articles by this author Serge Ginzburg More articles by this author Thomas Guzzo More articles by this author Thomas Lanchoney More articles by this author Jay Raman More articles by this author Jeffrey Tomaszewski More articles by this author Edouard Trabulsi More articles by this author Marc Smaldone More articles by this author Robert Uzzo More articles by this author Expand All Advertisement PDF downloadLoading ...