Login to Access Video or Poster Abstract: MP43-20
Sources of Funding: none

Introduction

Disparities exist with respect to race in the management of localized prostate cancer (PCa). We hypothesized that African American (AA) men with low and intermediate risk PCa (LIPCA) were more likely to choose non-definitive management (NDM) as well as less invasive treatment options versus Caucasian (CA) men.

Methods

We performed a retrospective cohort study of 219,862 patients diagnosed with LIPCa in the National Cancer Database from 2010-2013. Our primary endpoint was rates of NDM {active surveillance (AS) + watchful waiting (WW)} by AA men versus CA men. Our secondary endpoint was to identify the differences in treatment modalities between these two races. We performed multivariate logistic regression analysis that controlled for age, race, clinical stage, facility volume, facility location, facility type, insurance, Charlson comorbidity index, PSA, year of diagnosis, and geographic location.

Results

Of the 219,862 patients with LIPCa, 105,295 patients had NCCN low risk PCa and 114,567 patients had NCCN intermediate risk PCa. 179,372 (82%) were CA men, 31,358 (14%) AA men, and 9,132 (4%) Other Races. The median age for AA men, CA men, and Other Races was 61, 64, and 63 respectively. 21,544 (9.8%) of patients elected NDM and utilization was similar between CA men (9.6%) and AA men (9.9%) OR 1.098 p<0.001. As shown in Figure 1, Radical Prostatectomy (RP) was the most utilized treatment modality across all races but AA men were less likely than CA men to utilize this treatment (43.4% versus 53.5%), respectively p < 0.001. In addition, AA men were (8%) more likely to choose radiotherapy (RT) versus CA men, (38.1% versus 30%) p < 0.001. _x000D_ _x000D_

Conclusions

AA men with LIPCa choose NDM at similar rates to CA men, however this rate is relatively low at 9.8%. Notably, AA were more likely to choose RT and less likely to choose RP compared to CA men.

Funding

none