Racial Differences in the Diagnosis and Treatment of Prostate Cancer

被引:33
作者
Di Pietro, Giuliano [1 ]
Chornokur, Ganna [2 ]
Kumar, Nagi B. [2 ]
Davis, Chemar [2 ]
Park, Jong Y. [2 ]
机构
[1] Univ Fed Sergipe, Dept Pharm, Sao Cristovao, Brazil
[2] H Lee Moffitt Canc Ctr & Res Inst, Dept Canc Epidemiol, Tampa, FL 33612 USA
关键词
Prostatic neoplasms; Healthcare disparities; African Americans; GENOME-WIDE ASSOCIATION; AFRICAN-AMERICAN MEN; RISK LOCI; SUSCEPTIBILITY; DISPARITIES; AGE; GENERALIZABILITY; POPULATION; STATISTICS; MULTIPLE;
D O I
10.5213/inj.1632722.361
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Disparities between African American and Caucasian men in prostate cancer (PCa) diagnosis and treatment in the United States have been well established, with significant racial disparities documented at all stages of PCa management, from differences in the type of treatment offered to progression-free survival or death. These disparities appear to be complex in nature, involving biological determinants as well as socioeconomic and cultural aspects. We present a review of the literature on racial disparities in the diagnosis of PCa, treatment, survival, and genetic susceptibility. Significant differences were found among African Americans and whites in the incidence and mortality rates; namely, African Americans are diagnosed with PCa at younger ages than whites and usually with more advanced stages of the disease, and also undergo prostate-specific antigen testing less frequently. However, the determinants of the high rate of incidence and aggressiveness of PCa in African Americans remain unresolved. This pattern can be attributed to socioeconomic status, detection occurring at advanced stages of the disease, biological aggressiveness, family history, and differences in genetic susceptibility. Another risk factor for PCa is obesity. We found many discrepancies regarding treatment, including a tendency for more African American patients to be in watchful waiting than whites. Many factors are responsible for the higher incidence and mortality rates in African Americans. Better screening, improved access to health insurance and clinics, and more homogeneous forms of treatment will contribute to the reduction of disparities between African Americans and white men in PCa incidence and mortality.
引用
收藏
页码:112 / 119
页数:8
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