To assess racial differences in secondary treatment receipt and mortality after primary treatment for localized prostate cancer, and to explore differences in the type of secondary treatment received among those who received secondary treatment.
Approach:
Study Design: Conducted a retrospective cohort study using Medicare claims data linked to SEER cancer registry data.
Cohort Definition: Defined two cohorts based on primary treatment type: radical prostatectomy or radiation therapy, controlling for individual and social characteristics.
Participant Criteria: Included non-Hispanic Black and non-Hispanic White patients aged 66 years or older diagnosed with localized prostate cancer between 2004 and 2017.
Key Findings:
Black men are 1.6 times more likely to be diagnosed with prostate cancer and more than 2 times more likely to die from it compared to White men.
Black patients receive fewer definitive treatments and experience delays in treatment compared to White patients.
Black patients have less frequent PSA surveillance tests, potentially leading to delays in secondary treatment.
Interpretation:
The study aims to determine if disparities in secondary treatment receipt contribute to racial differences in mortality outcomes among prostate cancer patients.
Limitations:
Medical claims data do not include detailed biological data or medical justifications for treatments.
Exclusion of patients with managed care coverage may limit generalizability.
Conclusion:
This study is the first to examine how secondary treatment receipt may contribute to racial disparities in mortality among prostate cancer patients.
