Racial differences in initial treatment for clinically localized prostate cancer. Results from the prostate cancer outcomes study.

摘要: OBJECTIVE: We examined whether there were racial differences in initial treatment for clinically localized prostate cancer and investigated demographic, socioeconomic, clinical, or tumor characteristics could explain any differences. DESIGN: Prospective cohort study. SETTING: Population-based registries Connecticut, Los Angeles, Atlanta. PARTICIPANTS: evaluated 1144 African-American non-Hispanic white men, aged 50 to 74 years, with diagnosed between October 1994 1995. MEASUREMENTS AND MAIN RESULTS: obtained clinical data from patient surveys medical record abstractions. reported adjusted percentages receiving derived multinomial logistic regression. found an interaction race aggressiveness. Among men more aggressive cancers (PSA > = 20 ng/mL Gleason score 8), African Americans less likely undergo radical prostatectomy than whites (35.2% vs 52.0%), but receive conservative management (38.9% 16.3%, P=.003). the 71% of subjects cancers, equally either radiation therapy (80.0% 84.5%, P=.2). CONCLUSIONS: be treated conservatively. These may reflect Americans' greater likelihood presenting pathologically advanced which surgery has limited effectiveness. cancers-the majority cases-there no undergoing therapy.