199 Background: Epidemiological studies have demonstrated that African-American (AA) men with prostate cancer have lower overall survival and cancer-specific survival rates than Caucasian (CA) men with prostate cancer. We aim to assess whether racial disparities exist for prostate cancer within an equal access health care system like the Veterans Affairs (VA) hospitals. Methods: A retrospective analysis of AA and CA with metastatic prostate adenocarcinoma diagnosed between 1995 to 2007 via the Veterans Affairs Central Cancer Registry was conducted. Age, Race and type of treatment received were studied with respect to overall survival by using log-rank and Kaplan-Meier analysis. Results: A total of 8,195 patients with advanced prostate cancer were analyzed, majority of them where CA (66.32%), 30.8% were AA and 2.8% belonged to other races. The median survival for AA was 2.71 years, 2.88 years in CA and 4.02 years in other races (P value <0.0001). Subgroup analysis based on treatment modality used showed the following median survival rates in years: No treatment (CA: 1.73, AA: 1.39, other races: 3.79, P<0.816), Hormonal therapy alone (CA: 2.51,AA: 2.45, Others:3.72, P<0.022), Radiation therapy alone (CA: 2.2, AA: 2.7, Others: 2.26, P<0.832), combined hormone and radiation therapy (CA: 2.71, AA: 2.31, Others: 6.64, P<0.029). However when CA and AA survival were compared excluding other races there was no statistically significant difference in survival irrespective of type of therapy received. Conclusions: In advanced prostate cancer, AA and CA have uniformly poor prognosis. Type of therapy received did not influence the survival of both races. The numbers for other races is too small to make a definitive conclusion regarding their prognosis. No significant financial relationships to disclose.
Racial differences in the PSA bounce in predicting prostate cancer outcomes after brachytherapy: Evidence from the Department of Veterans Affairs
