This racial difference in treatment may be one reason why black men are more likely to die from the disease, the study authors suggest. The paper appears in the April 2004 issue of the Journal of Urology.

Researchers compared treatments for Caucasian, Hispanic and African-American men from 1992-1999. Data from 142,340 men was obtained from the national Surveillance, Epidemiology and End Results registry, a population-based cancer registration system maintained by the National Cancer Institute.

The men were divided into categories based on whether they received watchful waiting or definitive treatment which includes surgery, external beam radiation therapy or brachytherapy (in which high-dose radioactive seeds are implanted in the prostate). Black men with moderate grade cancers were 36 percent less likely than white men to receive treatment, and Hispanic men were 16 percent less likely than white men to receive treatment.

The racial disparity was even more pronounced among men whose tumors were aggressive. Black men with aggressive cancers were half as likely as white men with similar disease to receive treatment; Hispanic men were 23 percent less likely than white men to receive treatment for aggressive cancer. Men with this aggressive form of prostate cancer are significantly more likely to die from the disease without treatment.

"We know African-American men are more likely to die from prostate cancer. However, when they are diagnosed with the most aggressive cancers, they are less likely to receive definitive treatment. This could possibly impact the reported racial disparity in prostate cancer mortality," says lead author Willie Underwood, M.D., an assistant professor of urology surgery in the U-
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Contact: Nicole Fawcett
nfawcett@umich.edu
734-764-2220
University of Michigan Health System
29-Mar-2004