Black American military veterans with aggressive prostate cancer who would benefit from surgery or radiation are less likely to get those treatments than men of other races, despite equal access to health care, a new study finds.
"Despite great strides in prostate cancer care over the past few decades, racial disparities in care persist, and there remains a lot to be done to better understand why this is happening and what we can do to finally close the gap," said senior investigator Dr. Danil Makarov, a urologic surgeon at NYU Langone's Perlmutter Cancer Center, in New York City.
For the study, the researchers analyzed the medical records of more than 35,000 men treated for prostate cancer by the U.S. Veterans' Health Administration from 2011 to 2017. Most were over 60 and had no other serious health issues.
The investigators found Black patients were 5% more likely to receive radiation or surgery than other patients, and patients of all races deemed likely to benefit from the treatments were 40% more likely to get them than those who did not need them.
But Black men most likely to benefit from surgery or radiation (those with aggressive prostate cancer who were otherwise healthy) were 11% less likely to get the treatments than other men of similar age and cancer severity, the researchers said in an NYU news release.
The findings were published online June 29 in the journal Cancer.
Study co-investigator Dr. Joseph Ravenell said, "Our study suggests, for reasons that remain unclear, that Black men who need treatment may be choosing against the most beneficial prostate cancer therapies (which are often more invasive), or that such 'high-benefit' treatments are not being offered to them as aggressively as they are to non-Black patients."
Ravenell, who is associate dean for diversity affairs and inclusion at NYU Langone, noted that previous studies have found that some Black men may be more concerned than non-Black patients about the side effects of aggressive treatments, including the risk of incontinence and erectile dysfunction.
Makarov added, "Our findings strongly indicate that patients and physicians should discuss fears, values and preferences when considering all of the relevant treatment options for prostate cancer."
The study also confirmed previous research showing that Black men are likely to be diagnosed with prostate cancer two years earlier than men of other races -- and more likely to be diagnosed with more aggressive cancer.
Prior research shows that Black American prostate cancer patients are three times more likely to die from the disease than non-Black patients.
The American Cancer Society has more on prostate cancer.
SOURCE: NYU Langone Health, news release, June 29, 2021