Geographic, age, and racial variation in the treatment of local/regional carcinoma of the prostate.

1995 ◽  
Vol 13 (1) ◽  
pp. 93-100 ◽  
Author(s):  
L Harlan ◽  
O Brawley ◽  
F Pommerenke ◽  
P Wali ◽  
B Kramer
Keyword(s):  
Radical Prostatectomy ◽  
Black Men ◽  
White Men ◽  
Geographic Area ◽  
Incidence Rates ◽  
Clear Trend ◽  
Younger Men ◽  
Choice Of Treatment ◽  
Regional Disease ◽  
Age Adjusted Rates

PURPOSE Prostate cancer is one of the most common cancers in men. Incidence rates increase with age and are substantially higher in black men than white men. This study examines the variations in the use of radical prostatectomy and radiation by geographic area, age, and race. MATERIALS AND METHODS Data from the National Cancer Institute's Surveillance, Epidemiology, and End-Results Program (SEER) were used to examine treatment differences. Current treatments generally consist of prostatectomy, radiation, or careful observation for clinically localized or regional disease. RESULTS The age-adjusted proportion of men, age 50 and older, who received radical prostatectomy increased sharply between 1984 and 1991, from 11.0% to 32.3% among men with local/regional disease. The choice of treatment varied widely by geographic regions. In 1991, the proportion that received prostatectomy was highest in Utah (47.8%) and lowest in Connecticut (22.5%) among men with localized and regional disease. The increase in radical prostatectomy was not limited to younger men. Although the rates increased for blacks, black men had lower age-adjusted rates of prostatectomy than whites in all years of the study. CONCLUSION The SEER data show a clear trend toward more aggressive treatment, especially prostatectomy. However, the proportion of black men who received prostatectomy was substantially lower than that of white men and this disparity does not appear to be changing.

Increasing Incidence of Testicular Germ Cell Tumors Among Black Men in the United States

2005 ◽  
Vol 23 (24) ◽  
pp. 5757-5761 ◽  
Author(s):  
Katherine A. McGlynn ◽  
Susan S. Devesa ◽  
Barry I. Graubard ◽  
Philip E. Castle
Keyword(s):  
United States ◽  
Germ Cell ◽  
Black Men ◽  
Germ Cell Tumors ◽  
White Men ◽  
The United States ◽  
Incidence Rates ◽  
Seer Program ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell

Purpose There has been marked disparity in the incidence of testicular germ cell tumors (TGCT) among white and black men for a number of decades in the United States. Since at least the beginning of the Surveillance, Epidemiology, and End Results (SEER) Program in 1973, incidence rates among white men have been five times higher than rates among black men. In addition, rates among white men have been increasing, whereas rates among black men have remained stable. However, a recent examination of ethnic-specific rates suggested that the incidence among black men may have begun to change in the 1990s. Patients and Methods TGCT incidence data from nine registries of the SEER Program were analyzed for the years 1973 to 2001. Trends were examined separately for seminoma and nonseminoma. Results Analyses found that the incidence of TGCT began to increase among black men between the 1988 to 1992 and 1993 to 1997 periods. Before that time, incidence among black men had decreased by 14.8%. Between 1988 to 1992 and 1998 to 2001, however, the incidence increased by 100%, with the incidence of seminoma increasing twice as much (124.4%) as the incidence of nonseminoma (64.3%). Over the 29-year time period, there was no evidence of a change in the proportion of tumors diagnosed at earlier stages among black men. In contrast, the proportion of tumors diagnosed at localized stages significantly increased among white men. Conclusion The incidence of TGCT among black men has increased since 1988 to 1992. Although the reasons for this increase are unclear, screening and earlier diagnosis of TGCT do not seem to be factors.

Interaction of obesity and race in predicting recurrence rates after radical prostatectomy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5070-5070
Author(s):  
D. J. Lee ◽  
C. Ritch ◽  
M. Desai ◽  
J. M. McKiernan
Keyword(s):  
Radical Prostatectomy ◽  
Black Men ◽  
Independent Predictor ◽  
Disease Free Survival ◽  
White Men ◽  
Biochemical Failure ◽  
Accurate Estimation ◽  
Recurrence Rates ◽  
Free Survival ◽  
Disease Free

5070 Background: Black men are twice as likely to die from prostate cancer compared to white men. Obese men are known to have higher mortality rates and recurrence rates, and blacks are 1.4 times as likely to be obese than white Americans. However, the relative contribution of BMI and race to biochemical failure (BCF) after radical prostatectomy (RP) has not been well-characterized. We examined the interaction of BMI and race in predicting BCF after RP. Methods: A retrospective analysis of the Columbia Urologic Oncology Database found that 3,736 consecutive men underwent RP between 1988 and 2008. 1,461 men had BMI and race data available. 213 (14.6%) were black men, 1,004 (68.7%) were white, 162 (11.1%) were Hispanic, and 82 (5.6%) were Asian. Overweight and obese men were defined as having a BMI > 25 kg/m2 and a BMI > 30 kg/m2, respectively. BCF was defined as a post-surgery PSA level >0.2 ng/mL on > 2 measurements. Cox regression methods were used to model the relationship between race, BMI and BCF. Results: The 1,461 men had a median age of 60 years, and median pre-operative PSA of 5.5. There was no significant difference in BMI among the four races (p = 0.58). The 5 year disease-free survival for black obese men was the lowest at 69%, compared to non-obese black (71%), obese white (80%), and non-obese white men (80%, p < 0.001). BMI did not have a significant impact on BCF. After adjusting for preoperative PSA level, tumor stage, and Gleason sum, race remained an independent predictor of BCF (HR = 1.65, p = 0.04). An analysis assessing the effect of an interaction between race and BMI demonstrated that hazard ratios for increased BMI did not differ significantly by race. Black men who were normal, overweight and obese were 2.0, 3.0 and 2.5 times more likely than white men to have BCF in the respective weight categories, but the differences were not significant. Conclusions: Black race is an independent predictor of biochemical failure after adjusting for pathologic factors. The impact of BMI on BCF did not vary among different races. However, BMI does contribute to the accurate estimation of the risk of BCF. These findings suggest that elevated BMI does not affect the BCF rates of black men more than in other races, and that other factors may influence the racial variability in disease-free survival and BCF risk. No significant financial relationships to disclose.

1030: Do Younger Men have Better Biochemical Outcomes Following Radical Prostatectomy?

2004 ◽  
Vol 171 (4S) ◽  
pp. 272-272
Author(s):  
Stephen J. Freedland ◽  
Joseph C. Presti ◽  
Christopher J. Kane ◽  
William J. Aronson ◽  
Martha K. Terris ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Younger Men

scholarly journals Incidence and Trends of the Leading Cancers with Elevated Incidence Among American Indian and Alaska Native Populations, 2012–2016

2020 ◽  
Author(s):  
Stephanie C Melkonian ◽  
Hannah K Weir ◽  
Melissa A Jim ◽  
Bailey Preikschat ◽  
Donald Haverkamp ◽  
...  
Keyword(s):  
American Indian ◽  
Cancer Incidence ◽  
Alaska Native ◽  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Breast Cancers ◽  
Age Adjusted Rates ◽  
Incident Cases ◽  
Hispanic White

Abstract Cancer incidence varies among American Indian and Alaska Native (AI/AN) populations, as well as between AI/AN and White populations. This study examined trends for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations and estimated potentially avoidable incident cases among AI/AN populations. Incident cases diagnosed during 2012–2016 were identified from population-based cancer registries and linked with the Indian Health Service patient registration databases to improve racial classification of AI/AN populations. Age-adjusted rates (per 100,000) and trends were calculated for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations (rate ratio &gt;1.0), by region. Trends were estimated using joinpoint regression analyses. Expected cancers were estimated by applying age-specific cancer incidence rates among non-Hispanic White populations to population estimates for AI/AN populations. Excess cancer cases among AI/AN populations were defined as observed minus expected cases. Liver, stomach, kidney, lung, colorectal and female breast cancers had higher incidence rate among AI/AN populations across most regions. Between 2012 and 2016, nearly 5,200 excess cancers were diagnosed among AI/AN populations, with the largest number of excess cancers (1,925) occurring in the Southern Plains region. Culturally informed efforts may reduce cancer disparities associated with these and other cancers among AI/AN populations.

scholarly journals A review of new hormonal therapies for prostate cancer in black men: is there enough data?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthias E. Meunier ◽  
Pascal Blanchet ◽  
Yann Neuzillet ◽  
Thierry Lebret ◽  
Laurent Brureau
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Androgen Receptor ◽  
Black Men ◽  
White Men ◽  
Molecular Characteristics ◽  
Black Patients ◽  
First Results ◽  
Black Populations ◽  
Hormonal Therapies

Abstract Background Prostate cancer among black men is known to have specific molecular characteristics, especially the androgen receptor or enzymes related to the androgen metabolism. These targets are keys to the action of new hormonal therapies. Nevertheless, literature has a lack of data regarding black men. We aimed to gather the available literature data on new hormonal therapies among black populations. Methods We conducted a literature review from the PubMed / MEDLINE database until October 2020. All clinical studies of new hormonal therapies and black populations, regardless of methodology, were included. Results Four studies provided data on new hormonal therapies in black populations. Three studies reported a PSA decline in black patients treated with Abiraterone, higher in black men than in white men. Overall survival also appears to be higher in black patients treated with Abiraterone only or first. Conclusion Few articles have evaluated the effectiveness and safety of use of these treatments among black populations. The first results seem to show that Abiraterone can provide a benefit in overall survival in black populations. Prospective studies are needed to answer these questions in the future.

Abstract 15642: Race Sex Disparities in Atherosclerotic Cardiovascular Disease in Hospitalized Patients With Diabetes, 2005-2015 Potential Warning Signs for Future U.S. Public Health

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gursukhman Sidhu ◽  
Charisse J Ward ◽  
Keith Ferdinand
Keyword(s):  
Cardiovascular Disease ◽  
Renal Failure ◽  
Black Women ◽  
Black Men ◽  
Odds Ratio ◽  
White Men ◽  
The United States ◽  
Atherosclerotic Cardiovascular Disease ◽  
Secondary Diagnosis ◽  
The U.S

Introduction: Despite a recent gradually slowing and perhaps recent increase in the burden of atherosclerotic cardiovascular disease (ASCVD) related hospitalization in the United States population with diabetes, it is unclear whether the prior downward trend was uniform or there was an unbalanced division amongst sex and race. Methods: Adults aged ≥40 years old with comorbid diabetes as a secondary diagnosis were identified using the U.S. 2005-2015 National (Nationwide) Inpatient Sample (NIS) data. The prevalence of other modifiable cardiovascular risk factors (hypertension, dyslipidemia, smoking/substance abuse, obesity, and renal failure), procedures like major amputations in the secondary diagnosis field and their association with ASCVD (acute coronary syndrome (ACS), coronary artery disease (CAD), stroke, or peripheral arterial disease (PAD)) as the first-listed diagnosis were determined. Complex samples multivariate regression was used to determine the odds ratio (O.D.) with 95% confidence limits (C.L.s). Sex and race risk-adjusted ASCVD related in-hospital mortality rates were estimated. Results: The rate of total ASCVD hospitalizations adjusted to the U.S. census population increased by 5.7% for black men compared to 4% for black women cumulatively compared to a stable downtrend in white men and white women. There was a higher odd of an ASCVD hospitalizations if there was comorbid hypertension (Odds Ratio (OR 1.29; 95% Confidence Interval (CI) 95% 1.28 - 1.31), dyslipidemia (OR 2.03; 95% CI 2.01 - 2.05), renal failure (OR 1.84; 95% CI 1.82 - 1.86), and smoking/substance use disorder (OR 1.31; 95% CI 1.29 - 1.33). When compared to white men, black men (OR 1.43; 95% CI 1.3 - 1.57) and black women (OR 1.15; 95% CI 1.04 - 1.27) had a higher likelihood of undergoing a major limb amputation during an ASCVD hospitalization. Conclusions: Blacks with diabetes continue to have a higher hospitalizations burden with a concomitant disparity in procedures and outcomes.

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