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.
Prostate cancer and prostatic diseases. 2022 Mar 19 [Epub ahead of print]
Nishwant Swami, Yefri A Baez, Idalid Franco, Tiffany Nguyen, Karthik Meiyappan, Minh Ton, Bhav Jain, Crystal Seldon, Kenrick Ng, Narjust Duma, Mohammed Alshalalfa, Kosj Yamoah, Paul L Nguyen, Brandon A Mahal, Edward Christopher Dee
University of Massachusetts Medical School, Worcester, MA, USA., Department of Urology, Brigham and Women's Hospital, Boston, MA, USA., Harvard Medical School, Boston, MA, USA., University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Fl, USA., Massachusetts Institute of Technology, Cambridge, MA, UK., Department of Radiation Oncology, University of Miami/Jackson Memorial Hospital, Miami, USA., Department of Medical Oncology, Mount Vernon Cancer Centre, Northwood, UK., Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA., Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, Fl, USA., Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Fl, USA. ., Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .