Racial disparities in late-stage prostate cancer: A SEER database analysis 2005–2015.
115 Background: Incidence of metastatic prostate cancer in U.S. males has increased over the past ten years, but it is unknown how this trend varies over time within different racial and ethnic populations. Methods: We identified all men first diagnosed with prostate cancer from 2005-2015 in the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, which monitors 18 population-based cancer registries. Yearly cancer diagnosis frequency from 2005 to 2015 was categorized and analyzed by stage (in situ/localized, regional, and distant), race/ethnicity [White, Asian American/Pacific Islander (AAPI), Black], and age group (45-54, 55-69, 70-75). Chi-square tests, multivariable logistic regression models were used for data analysis with p < 0.05 considered significant. Results: In the 10-year study period, the proportion of regional-stage prostate cancer increased from 14.2% to 16.6% of cases (p < .0001) and distant-stage increased from 3.3% to 5.8% (p < .0001). The odds of being diagnosed with regional-stage prostate cancer in 2013-2015 compared to 2005-2008 were 1.3 times higher for Black men (95% CI: 1.2-1.5), 1.3 times higher for AAPI men (95% CI: 1.1-1.5), and 1.2 times higher for White men (95% CI: 1.2-1.3). The odds of being diagnosed with distant-stage prostate cancer in 2013-2015 compared to 2005-2008 were 1.6 times higher for Black men (95% CI: 1.4-1.9), 1.8 times higher for AAPI men (95% CI: 1.5-2.3), and 2.1 times higher for White men (95% CI: 1.9-2.2). Conclusions: The incidence of late-stage prostate cancer has increased significantly in all US male despite race and ethnicity. However, reginal-stage prostate cancer increased the most over time in AAPI and Black men, while newly-diagnosed distant prostate cancer increased the most over time in White men.