Black veterans with advanced prostate cancer least likely to receive beneficial treatment, says HAV

Within the Veteran’s Health Administration (VHA), race does not appear to influence receipt of definitive treatment. However, according to the results of a study published in Cancer.¹

Study results indicated that black veterans with prostate cancer were 5% more likely to receive radiation therapy or surgery than non-black patients (P <.001>2 Additionally, Veterans of all races who were likely to benefit from definitive treatment were 40% more likely to receive treatment than those who did not (P <.001 despite the benefits of advanced care that is currently available for this patient population black men who were very likely to benefit from treatment less receive than non-black patients age and severity age. disease similar ratio>P <.001>

“Our study suggests, for reasons that remain unclear, that black men who need treatment may choose the most beneficial prostate cancer therapies (which are often more invasive), or that such treatments.” benefit “are not offered to them as aggressively as they are to non-black patients,” co-investigator Joseph Ravenell, MD, associate dean for diversity and inclusion affairs at New York University (NYU) Langone, associate professor at NYU Grossman School of Medicine, and community outreach and engagement co-leader at Perlmutter Cancer Center, said in a press release.

Previous findings have indicated that black patients are less likely to undergo definitive treatment for prostate cancer than men of other races. However, it remains to be determined whether this is due to avoidance of overtreatment in people with low-risk disease and life-changing side effects, such as erectile dysfunction and incontinence. Another reason for these disparities could be a reduction in appropriate care. This inspired the study researchers to examine the role of race in the benefits of prostate cancer treatment.

Investigators behind the retrospective cohort study identified 35,427 men through the VHA Corporate Warehouse who had been diagnosed with low to intermediate risk disease from 2011 to 2017. The majority of people included in the study had over 60, were married and had no notable comorbidities.

The men were characterized based on life expectancy and disease severity. For example, while a man in his 50s with an aggressive disease who has undergone surgery or radiation therapy would be considered a high benefit patient, older men with non-aggressive prostate cancer would be classified as low benefit.

Additional study results indicated that black patients are more often diagnosed with prostate cancer 2 years earlier than patients of other racial groups of all ages. However, this population is more likely to be diagnosed with a more aggressive disease. More research needs to be done to identify the forces responsible for these racial disparities.

“Despite great advances in prostate cancer care over the past decades, racial disparities in care persist, and much remains to be done to better understand why this is happening and what we can do to finally close it. ‘difference. Ultimately, our goal is to provide patients with the most appropriate cancer care they need, using a culturally sensitive approach, ”Danil Makarov, MD, MHS, Associate Professor, Departments of Urology and Population Health from NYU Grossman School of Medicine, concluded.

The references

1. Study sheds light on persistent racial disparities in prostate cancer care in the United States. Press release. NYU Langone Health. June 29, 2021. https://bit.ly/2VAt4V7
2. Rude T, Walter D, Ciprut S, et a. Interaction Between Race and Prostate Cancer Treatment Benefit in the Veterans Health Administration. Cancer. Published online June 29, 2021. doi: 10.1002 / cncr.33643