Abstract B47: Racial/ethnic disparities in prostate cancer survival

Background: Few studies have examined racial/ethnic differences in prostate cancer survival in association with socioeconomic status, and no studies have examined this relationship for men in Texas. The objective of this analysis is to determine whether racial disparities in survival for men with prostate cancer in Texas from 1995 to 2002 remain after adjusting for socioeconomic status, rural residence, and stage of disease.

Methods: A cohort of 87,449 men diagnosed with prostate cancer at age 18 years or older was identified from the Texas Cancer Registry (TCR). Socioeconomic status (SES) was based on census tract data reflecting median household income, proportion below poverty, proportion with a college education, proportion with a management/professional occupation, and median home value. Five-year survival was calculated using the Kaplan-Meier method. Cox proportional hazard modeling was used to estimate all-cause and disease-specific hazard ratios (HR) of mortality and 95% confidence intervals (CI).

Results: After adjusting for SES, age, stage, tumor grade, year of diagnosis and rural residence, non-Hispanic black men were more likely (aHR=1.36; 95%CI: 1.30–1.42) and Asian/Pacific Islander men were less likely (aHR=0.65; 95%CI: 0.52–0.82) to die of all causes when compared with non-Hispanic white men. Both non-Hispanic black men and Hispanic men were more likely (aHR=1.69; 95%CI: 1.57–1.82; aHR=1.11; 95%CI: 1.02–1.20, respectively) to die of prostate cancer relative to non-Hispanic white men.

Conclusions: Substantial racial disparities in survival were found for men with prostate cancer in Texas that were not explained by SES. Future studies should incorporate treatment data as well as comorbid conditions, which may help explain these survival disparities.