Affiliation:
1. Division of Nephrology Department of Medicine, The Metrohealth System Cleveland Ohio USA
2. Department of Medicine Case Western Reserve University School of Medicine Cleveland Ohio USA
3. Population and Quantitative Health Sciences, Population Cancer Analytics Shared Resource, and the Case Comprehensive Cancer Center Case Western Reserve University Cleveland Ohio USA
Abstract
AbstractBackgroundBlack men and men with end‐stage kidney disease have lower rates of treatment and higher mortality for prostate cancer. We studied the interaction of end‐stage kidney disease (ESKD) with Black race for treatment rates and mortality for men with prostate cancer.Methods and ResultsWe included 516 Black and 551 White men with ESKD before prostate cancer 22,299 Black men, and 141,821 White men without ESKD who were 40 years or older from the Surveillance, Epidemiology, and End‐Results‐Medicare data (2004–2016). All Black men with or without ESKD and White men with ESKD had higher prostate‐specific antigen levels at diagnosis than White men without ESKD. Black men with ESKD had the lowest rates for treatment in both local and advanced stages of prostate cancer (age‐adjusted risk ratio: 0.76, 95% Confidence Interval (CI): 0.71–0.82 for local stage and age‐adjusted risk ratio: 0.82, 95% CI: 0.76–0.9 for advanced stages) compared to White men without ESKD. Compared to White men without ESKD, prostate cancer‐specific mortality was higher in White men with ESKD for both local and advanced stages (age‐adjusted hazard ratio: 1.8, 95% CI: 1.2–2.8 and HR: 1.6, 95% CI: 1.2–2.2) and it was higher for ESKD Black men only in advanced stage prostate cancer (age‐adjusted hazard ratio: 2.4, 95% CI: 1.5–3.6).ConclusionOur findings suggest that having a comorbidity such as ESKD makes Black men more vulnerable to racial disparities in prostate cancer treatment and mortality.
Reference22 articles.
1. Institute of Medicine.Unequal TreatmentConfronting Racial and Ethnic Disparities in Healthcare. Accessed March 13 2023.https://nap.nationalacademies.org/read/12875/chapter/1
2. United States Renal Data System 2023 Annual Data Report: End Stage Renal Disease.Incidence Prevalence Patient Characteristics and Treatment Modalities. Accessed December 15 2023.https://usrds‐adrniddknihgov/2023/end‐stage‐renal‐disease/1‐incidence‐prevalence‐patient‐characteristics‐and‐treatment‐modalities
3. Cancer Stat Facts: Prostate Cancer. Accessed December 15 2023.https://seer.cancer.gov/statfacts/html/prost.html
4. Prostate Cancer, Kidney Transplant Wait Time, and Mortality in Maintenance Dialysis Patients: A Cohort Study Using Linked United States Renal Data System Data
5. The changing landscape of cancer in the USA — opportunities for advancing prevention and treatment