Black men with advanced prostate cancer are less likely to receive more aggressive treatments, a new study has found. Photo by Joshua Woroniecki/Pixabay
June 29 (UPI) -- Black men with advanced prostate cancer are less likely to receive aggressive treatments than White and Hispanic men with the disease, a study published Tuesday by the journal Cancer found.
The study of military veterans found that Black male veterans were somewhat more likely to receive radiation or surgery for prostate cancer than non-Black men, despite finding that Black men overall were less likely to receive the treatments.
In addition, veterans of all races who stood to benefit from these more aggressive treatments were 40% more likely to receive them compared with those who did not need them.
However, Black men are also more likely to be diagnosed with prostate cancer two years earlier than men of other races across all age groups.
And they are also more likely to be diagnosed with more aggressive forms of the disease than men in other racial and ethnic groups, the data showed.
These disparities exist despite apparent equal opportunities in obtaining health care services, at least among U.S. veterans, the researchers said.
"The subset of Black men in the high-benefit group were less likely to receive treatment than non-Black men in the same treatment category," study co-author Dr. Danil Makarov told UPI in an email.
This "reveals a racial disparity," said Makarov, an associate professor of urology and population health at NYU Grossman School of Medicine in New York City.
The reasons for this disparity, "remain unclear," though it may be that these "high- benefit treatments are not being offered to Black patients as aggressively as they are to non-Black patients, Makarov and his colleagues said.
For this study, Makarov and his colleagues analyzed the medical records of 35,427 men treated for early to moderate prostate cancer at U.S. Veterans Health Administration facilities between 2011 and 2017.
Most of the men included in the study were over age 60, were married and had no other serious health issues, the researchers said.
They identified all men diagnosed with prostate cancer and categorized them by their life expectancy, based on their other medical diagnoses, and the severity of their prostate cancer.
For example, men in their 50s with aggressive cancer who had surgery or radiation were deemed to have received "high-benefit" treatment because it had the greatest impact on their life expectancy.
Conversely, much older men with non-aggressive cancers would have been assessed as "low" benefit for aggressive prostate cancer treatments because these treatments would have had little impact on their life expectancy, the researchers said.
Black men most likely to benefit from high-benefit treatments -- those with aggressive prostate cancer who were otherwise healthy -- were 11% less likely to get them than non-Black men of similar age and cancer severity, the data showed.
One possible reason for this treatment disparity is that some Black men may have greater fears than others about side effects of aggressive therapy, such as the risk of incontinence and erectile dysfunction, the researchers said.
Prostate cancer remains the second-leading cause of cancer death among men in the United States, with more than 34,000 dying annually from the disease and Black men three times more likely to die from the disease than others, according to the National Cancer Institute.
Nearly 250,000 men will be diagnosed with prostate cancer in 2021, most in its earliest stages, the institute estimates.
"The driver of these disparities is unclear, but it is possible that it could be a combination of patient-, provider- and system-level factors," Makarov said.
"It is also possible that patient race and cultural factors may discourage care-seeking and contribute to this treatment disparity, [so] further investigation is warranted," he said.