(HealthDay)—After adjustment for nonbiological differences, black race is not associated with worse prostate cancer-specific mortality among men with nonmetastatic prostate cancer, according to a study published online May 23 in JAMA Oncology.
Robert T. Dess, M.D., from the University of Michigan in Ann Arbor, and colleagues evaluated the association of black race with long-term prostate cancer survival outcomes among men with nonmetastatic prostate cancer. Data were used from the Surveillance, Epidemiology, and End Results U.S. population registry (SEER; 296,273 patients; 17.8 percent black), five equal-access regional medical centers within the Veterans Affairs health system (VA; 3,972 patients; 38.1 percent black), and four pooled National Cancer Institute-sponsored Radiation Therapy Oncology Group phase 3 randomized clinical trials (RCT cohort; 5,854 patients; 19.3 percent black).
The researchers found that in the SEER cohort, black race was associated with an increased age-adjusted prostate cancer-specific mortality (PCSM) hazard (subdistribution hazard ratio [sHR], 1.30; 95 percent confidence interval [CI], 1.23 to 1.37; P < 0.001). Ten years postdiagnosis and after inverse probability weighting adjustment, black race was associated with a 0.5 percent increase in PCSM (sHR, 1.09; 95 percent CI, 1.04 to 1.15; P < 0.001). There was no significant difference for high-risk men (sHR, 1.04; 95 percent CI, 0.97 to 1.12; P = 0.29). In the VA cohort, there were no significant differences in PCSM (sHR, 0.85; 95 percent CI, 0.56 to 1.30; P = 0.46). In the RCT cohort, black men had a significantly lower hazard (sHR, 0.81; 95 percent CI, 0.66 to 0.99; P = 0.04). Other-cause mortality was significantly higher among black men in the SEER (sHR, 1.30; 95 percent CI, 1.27 to 1.34; P < 0.001) and RCT (sHR, 1.17; 95 percent CI, 1.06 to 1.29; P = 0.002) cohorts when adjusting for other variables.
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