The study find that the prostate cancer in an analysis that looked at how black and white men had fared when treated in settings where patients had standardized access to care. Previous research found that black men were nearly 2.5 times more likely to die of prostate cancer when compared with non-Hispanic white men; note the authors; led by Robert T. Dess, MD, of the University of Michigan.
Non-Hispanic white men
In their study, they set out to find how much of this difference could be attributed to access to care. They contrasted results from a large federal registry; therefore which they write reflects “multiple socioeconomic barriers to quality care” experienced by black men; to those from two settings where care was more standardized.
These were the Veterans Affairs (VA) health system and the Radiation Therapy Oncology Group phase 3 randomized clinical trials (RCTs); sponsored by the National Cancer Institute (NCI). For men who were treated within systems with equal access to care (VA cohort) or within the standardized treatment approach and follow-up of a cooperative group trial (RCT cohort); there was no difference in the prostate cancer specific mortality (PCSM) rates between black and white patients.
National Cancer Institute
This finding adds to a growing body of evidence pointing to gaps in treatment, and not race itself; as a cause of higher mortality rates for black men from prostate cancer, the authors comment. In an invited commentary; Channing J. Paller, MD; Lin Wang, MSc, MMed; and Otis W. Brawley, MD, all of Johns Hopkins University, write that the new research provided “powerful evidence that equal treatment yields equal outcome among equal patients.”
“It is an unsettling fact that there is not equal treatment in the United States. African Americans, other minorities, and the poor in general often experience disparate quality of care or no care at all;” the editorialists comment. There could be genomic factors at play in the experience of black men with prostate cancer, which merit further research, they add. However, they emphasize a need to immediately improve the care of black patients.
Improve the care
“They as health care professionals are likely to have the greatest effect on improved outcomes for African American patients with prostate cancer by ensuring that they get the same care as white patients, not just in clinical trials but throughout the national health care system,” the editorialists add.The study was designed to tease out the effects of access to care in outcomes. To represent the general population, the authors used the NCI’s Surveillance, Epidemiology, and End Results (SEER) database, which reports age-adjusted PCSM rates.