Racial disparities in mortality for patients with prostate cancer after radical prostatectomy
| العنوان: | Racial disparities in mortality for patients with prostate cancer after radical prostatectomy |
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| المؤلفون: | Amy N. Luckenbaugh, Christina E Bayley, Wanqing Wen, David F. Penson, Xiao-Ou Shu |
| المصدر: | Cancer. 127:1517-1528 |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Cancer Research, Native Hawaiian or Other Pacific Islander, medicine.medical_treatment, Black People, Health Services Accessibility, White People, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Asian People, Humans, Medicine, 030212 general & internal medicine, Healthcare Disparities, Proportional Hazards Models, Prostatectomy, business.industry, Proportional hazards model, Inverse probability weighting, Hazard ratio, Age Factors, Prostatic Neoplasms, Cancer, Hispanic or Latino, Middle Aged, medicine.disease, Confidence interval, Survival Rate, Socioeconomic Factors, Oncology, 030220 oncology & carcinogenesis, Pacific islanders, business, Demography |
| الوصف: | Background Although racial disparities in prostate cancer survival are well documented, the relative importance of contributing factors remains unclear. Few studies have examined the disparity between Whites and Hispanics or between Whites and Asian Americans and Pacific Islanders (AAPIs). Methods Using data from the National Cancer Database for 526,690 patients with prostate cancer who underwent radical prostatectomy between 2004 and 2014, this study systematically evaluated the impact of clinical characteristics and factors related to access to care on survival by race. Included in the analysis were 432,640 White patients (82.1%), 63,602 Black patients (12.1%), 8990 AAPI patients (1.7%), and 21,458 Hispanic patients (4.1%). Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals to measure racial survival disparities. Inverse probability weighting was used to adjust for imbalances of prognostic factors. Results When adjustments were made for age and year of diagnosis only, Blacks had 51% higher mortality, AAPIs had 22% lower mortality, and Hispanics had 6% lower mortality than Whites. Overall, with adjustments for all clinical factors and nonclinical factors, the Black-White survival disparity narrowed to 20%, whereas the AAPI-White disparity increased to 35%. Among the controlled-for factors, education, median household income, and insurance status contributed the most to the racial disparity. Conclusions The overall survival disparity among men undergoing radical prostatectomy was significantly decreased, but not eliminated, for Blacks and significantly increased for AAPIs in comparison with Whites after adjustments for a number of clinical factors and factors related to access to care. |
| تدمد: | 1097-0142 0008-543X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::adc324af2db8718316f7acdff12af223Test https://doi.org/10.1002/cncr.33152Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....adc324af2db8718316f7acdff12af223 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10970142 0008543X |
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