Centers for Disease Control and Prevention, Atlanta, GA
David A Siegel , Mary Elizabeth O'Neil , Thomas B Richards , Nicole F Dowling , Hannah K Weir
Background: Prostate cancer is the most common cancer diagnosed and the second leading cause of cancer-related deaths among U.S. men. Incidence rates for distant stage cancer increased during 2010–2014, and survival at all stages was lower for black men than white men. We examined temporal changes in survival by race/ethnicity. Methods: Five-year relative survival (RS) (cancer survival in the absence of other causes of death) was calculated for men with prostate cancer aged ≥40 years using National Program of Cancer Registries data (93% U.S. population coverage). Cancers were diagnosed during 2001–2015 with follow-up through 2015. RS was estimated by race/ethnicity (non-Hispanic white, non-Hispanic black, and Hispanic), stage, and year (2001–2007 and 2008–2015). Differences were determined by non-overlapping 95% confidence intervals (CI). Results: During 2001–2015, 2,234,233 cases were recorded. Five-year RS was 100% for localized disease in all race/ethnicities and time periods. Overall, RS improved from 29.0% (95% CI, 28.5–29.5) to 31.3% (30.8–31.9) for distant stage and 83.4% (83.0–83.8) to 84.7% (84.2–85.1) for unknown stage. For regional stage, RS improved for white men (table). For distant stage, RS was highest for black and Hispanic men. For unknown stage, RS was highest for white and Hispanic men. Conclusions: RS improved for regional, distant, and unknown stage, but disparities by race/ethnicity persist. The disparity between black and white men for distant stage reversed compared to past studies. Further investigation of diagnosis patterns and clinical characteristics of men with distant and unknown stage cancer could inform interventions to address disparities in outcomes.
Stage | Race/ethnicity | No., 2001–2007 | RS (95% CI), 2001–2007 | No., 2008–2015 | RS (95% CI), 2008–2015 | |
---|---|---|---|---|---|---|
Regional | White | 100,214 | 97.9 (97.7–98.2) | 132,175 | 99.4 (99.1–99.6) | |
Black | 15,966 | 98.4 (97.6–98.9) | 23,094 | 99.1 (98.2–99.5) | ||
Hispanic | 7,544 | 96.8 (95.9–97.5) | 11,547 | 98.1 (97.2–98.7) | ||
Distant | White | 36,398 | 27.5 (27.0–28.1) | 53,859 | 29.4 (28.8–30.1) | |
Black | 10,784 | 29.9 (28.9–30.9) | 14,774 | 32.2 (31.1–33.4) | ||
Hispanic | 3,835 | 35.4 (33.7–37.1) | 6,310 | 38.7 (36.9–40.5) | ||
Unknown | White | 83,667 | 83.2 (82.7–83.6) | 61,482 | 81.1 (80.5–81.7) | |
Black | 15,645 | 78.3 (77.2–79.3) | 14,914 | 77.9 (76.7–79.0) | ||
Hispanic | 7,758 | 81.8 (80.4–83.0) | 9,762 | 86.0 (84.7–87.3) |
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