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Race and prostate specific antigen surveillance testing and monitoring 5-years after definitive therapy for localized prostate cancer

Prostate Cancer and Prostatic Diseases volume 24, pages 1093–1102 (2021)Cite this article

Subjects

Abstract

Background

Prostate-specific antigen (PSA) surveillance testing is a cornerstone of prostate cancer survivorship because patients with biochemical recurrence often have no symptoms. However, the investigation of guideline-concordant PSA surveillance across racial groups is limited. We examined racial differences in PSA surveillance testing 5-years post-definitive treatment for localized prostate cancer.

Methods

We created a population-based retrospective cohort from the Surveillance, Epidemiology, and End Results-Medicare linked database for men diagnosed with prostate cancer between the years 2007 to 2011 with Medicare claims through 2016 (N = 21,372). Multivariable log-binomial regression models were used to examine the effect of race on the likelihood of not receiving at least one PSA surveillance test annually 5-years post-definitive treatment.

Results

Black men had 90%, 71%, 44%, 34%, and 23% increased risk of not receiving at least one PSA surveillance test annually in the first, second, third, fourth, and fifth years of post-definitive treatment follow-up, respectively. The adjusted relative risk [ARR] for Black men compared to White men were 1.68 (95% Confidence Interval [CI], 1.37–2.07), 1.52 (95% CI, 1.32–1.75), 1.32 (95% CI, 1.17–1.48), and 1.16 (95% CI, 1.05–1.29) in the first, second, third, and fourth year of post-definitive treatment, respectively.

Conclusion

Black men were more likely not to receive guideline-concordant PSA surveillance testing following definitive treatment for localized prostate cancer during the first 4 years post-treatment. This study suggest room for improvement in defining survivorship care plans for Black men to increase use of PSA surveillance testing.

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Fig. 1: Study flow diagram displaying the sample counts for included and excluded observations, with the number of men excluded at each stage in the sample creation process.

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Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by National Cancer Institute Grant 1K01CA230193-01A1, National Institute of Health KL2 Scholars Grant KL2TR00238, National Center for Advancing Translational Sciences UL1 Diversity Supplement Grant 3UL1TR002378-02S2, and Institutional Research Grant-14-193-01 from the American Cancer Society.

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Authors and Affiliations

  1. University of Georgia, College of Pharmacy, Department of Clinical and Administrative Pharmacy, Division of Pharmaceutical Health Services, Outcomes, and Policy, Athens, Georgia

    Ibrahim M. Asiri, Henry N. Young & Ewan K. Cobran

  2. University of Kansas, School of Medicine, Department of Radiation Oncology, Kansas City, KS, USA

    Ronald C. Chen

  3. University of Georgia, College of Agricultural and Environmental Sciences, Department of Biological Science, Athens, Georgia

    Jason Codling

  4. Emory University, School of Medicine, Department of Hematology and Medical Oncology, Atlanta, Georgia

    Anant Mandawat

  5. University of Georgia, Franklin College of Arts and Sciences, Department of Psychology, Athens, Georgia

    Steven R. H. Beach

  6. Emory University, School of Medicine, Department of Urology, Atlanta, Georgia

    Viraj Master

  7. University of Georgia, College of Public Health, Department of Health Policy & Management, Athens, Georgia

    Janani Rajbhandari-Thapa

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  1. Ibrahim M. Asiri
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Contributions

IMA: Conceptualization, formal analysis, software, and writing – review and editing. RCC: Formal analysis, software, and writing – review and editing. HNY: Conceptualization, formal analysis, software, and writing– review and editing. JC: Methodology, project administration, writing – original draft, and writing – review and editing. AM: Formal analysis, and writing– review and editing. SRHB: Conceptualization, formal analysis, and writing– review and editing. VM: Formal analysis, writing– review and editing. JR-T: Formal analysis, writing– review and editing. EKC: Conceptualization, formal analysis, funding acquisition, software, and writing – review and editing.

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Correspondence to Ewan K. Cobran.

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Asiri, I.M., Chen, R.C., Young, H.N. et al. Race and prostate specific antigen surveillance testing and monitoring 5-years after definitive therapy for localized prostate cancer. Prostate Cancer Prostatic Dis 24, 1093–1102 (2021). https://doi.org/10.1038/s41391-021-00365-w

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