Moffitt Cancer Center, Tampa, FL
Muhammad Zain Farooq , Trilok Shrivastava , Humaira Sarfraz , Sheeba Habeeb Ba Aqeel , Pingfu Fu , Ankit Mangla
Background: Amongst all cancers in men, prostate cancer (PCa) is the most common cancer, and the second leading cause of death. Racial disparities in PCa care in the United States (US) are known to exist. However, it is not clear if this disparity is also noted specifically in patients diagnosed with metastatic PCa (metaPCa). We analyzed the Surveillance Epidemiology and End results Program (SEER) 18 registry, to determine the racial disparity in survival of AA patients diagnosed with metaPCa compared to other races recorded in this registry. Methods: Cancer incidence data was obtained from the SEER 18 registry (2000-2018). The data was analyzed using StataMP 16 (StataCorp) software. Demographic and clinical outcomes were recorded from the registry. We performed univariate Cox regression using proportional hazard model and obtained Kaplan Meier curves to look at the difference in survival based on different age groups and race. Results: A total of 51,979 cases were identified with metaPCa, out of whom 75.8% were Whites. 40,579 deaths were recorded. Mean age group of patients with metaPCa were 70-74 years. Grade 3 poorly differentiated adenocarcinoma was noted in 54.6% patients. There was no statistically significant difference in survival of AA patients with metaPCa compared to Non-Hispanic Whites (NHW) (Hazard Ratio (HR): 0.99; 95%CI 0.96,1.03 p = 0.71) or Alaskan and American Natives (AIAN) with metaPCa (HR:1.048; 95%CI 0.91,1.21 p = 0.539). AA with metaPCa had a statistically better outcome compared to Asian and Pacific Islanders with metaPCa (HR:0.775; 95%CI 0.731,0.821 p = 0.00). Amongst patients with less than 65 years of age with metaPCa, AA patients had statistically better survival than NHW (HR: 0.94; 95% CI 0.89-0.98 p = 0.05). No statistically supported racial disparity in survival was observed in patients above 65 years with metaPCa (AA to NHW patients- HR: 0.99; 95% CI 0.96,1.03 p = 0.71). Conclusions: Although racial disparities exist in survival of all patients diagnosed with prostate cancer, when it comes to those with metaPCA, there is no statistically supported racial disparity amongst AA patients compared to NHW, except for those who are younger than 65 years where white patients have a worse outcome compared to AA diagnosed with metaPCa.
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