Despite great heterogeneity amongst Hispanic groups, prostate cancer studies often report Hispanic patients in aggregate. We sought to identify differences in prostate cancer risk group at presentation and treatment status among Hispanic subgroup populations.
Patients with localized prostate adenocarcinoma diagnosed from 2004–2017 were identified in the National Cancer Database (NCDB) and disaggregated by racial subgroup and Hispanic country of origin. Ordinal logistic regression defined adjusted odds ratios (AORs) with 95% CI of (1) presenting at progressively higher risk group and (2) receiving treatment with intermediate-unfavorable or high-risk disease.
In our sample (n = 895,087), Hispanic men had greater odds of presenting with higher-risk localized prostate cancer compared with non-Hispanic White men (AOR = 1.18 95% CI 1.16–1.21, p < 0.001). Additionally, Hispanic Black men were less likely to present with higher-risk disease than non-Hispanic Black men. Disparities also existed when disaggregated by country of origin, particularly for Mexican men. Amongst men with unfavorable-risk disease, Hispanic men were less likely to receive treatment than non-Hispanic White men (95% CI 0.57–0.67, p < 0.001). The odds of Hispanic Black patients receiving treatment was 2.00 times the odds (95% CI 1.17–3.41 p = 0.011) of non-Hispanic Black patients receiving treatment. Upon disaggregation by country of origin, disparities persisted, particularly for Mexican men.
We found marked heterogeneity when risk group at presentation and treatment for higher-risk disease were disaggregated by racial subgroup and country of origin. Our findings support further collection of disaggregated data in Hispanic communities and study of potential mechanisms underlying the observed differences.
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The patient-deidentified National Cancer Database is available from the American College of Surgeons (https://www.facs.org/quality-programs/cancer/ncdb/puf) and is not owned by the authors of this work.
Stata code is available upon request from the first and/or corresponding author.
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BAM is funded by the Prostate Cancer Foundation and (PCF), the American Society for Radiation Oncology (ASTRO), the Department of Defense, and the Sylvester Comprehensive Cancer Center. IF is funded in part through a Diversity Supplement from the Center to Reduce Cancer Health Disparities, National Cancer Institute, National Institutes of Health. KN has received funding from Tesaro, Pfizer, Boehringer, Ingelheim, GlaxoSmithKline UK Ltd, and Conquer Cancer Foundation outside the submitted work. ND has received funding from AstraZeneca, Merck, Pfizer, BMS, Genentech, BI Oncology, Janssen, and Neogenomics outside the submitted work. KY reported support from Flatiron Inc and Janssen R&D outside the submitted work. PLN reported receiving grants and personal fees from Bayer, Janssen, and Astellas and personal fees from Boston Scientific, Dendreon, Ferring, COTA, Blue Earth Diagnostics, and Augmenix outside the submitted work; PLN is also funded in part through the NIH Grant R01-CA240582. ECD is funded in part through the NIH/NCI Support Grant P30 CA008748.
The authors declare no competing interests.
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Swami, N., Baez, Y.A., Franco, I. et al. Localized prostate cancer disparities in risk group at presentation and access to treatment for Hispanic men. Prostate Cancer Prostatic Dis (2022). https://doi.org/10.1038/s41391-022-00526-5