Clinical presentation and initial management of Black men and White men with prostate cancer in the United Kingdom: the PROCESS cohort study

被引:28
作者
Evans, S. [1 ,2 ]
Metcalfe, C. [1 ]
Patel, B. [1 ,2 ]
Ibrahim, F. [1 ]
Anson, K. [3 ]
Chinegwundoh, F. [4 ,5 ]
Corbishley, C. [3 ]
Gillatt, D. [6 ]
Kirby, R. [3 ]
Muir, G. [7 ]
Nargund, V. [4 ]
Popert, R. [8 ]
Wilson, P. [9 ]
Persad, R. [2 ]
Ben-Shlomo, Y. [1 ]
机构
[1] Univ Bristol, Dept Social Med, Bristol BS8 2PS, Avon, England
[2] Univ Hosp Bristol NHS Fdn Trust, Dept Urol, Bristol BS2 8HW, Avon, England
[3] St George Hosp, Dept Urol & Pathol, London SW17 0QT, England
[4] St Bartholomews Hosp, Dept Urol, Barts & London NHS Trust, London EC1A 7BE, England
[5] Newham Univ Hosp NHS Trust, Dept Urol, London E13 8SL, England
[6] Southmead Hosp, Dept Urol, N Bristol NHS Trust, Bristol BS10 5NB, Avon, England
[7] Kings Coll Hosp NHS Trust, Dept Urol, London SE5 9RS, England
[8] Guys Hosp, Guys & St Thomas NHS Fdn Trust, Dept Urol, London SE1 9RT, England
[9] Bristol Haematol & Oncol Ctr, Bristol Oncol Ctr, Bristol BS2 8ED, Avon, England
关键词
clinical management; diagnosis; epidemiology; ethnicity; prostate cancer; DIAGNOSIS; RACE/ETHNICITY; RECEIPT;
D O I
10.1038/sj.bjc.6605461
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: In the United States, Black men have a higher risk of prostate cancer and worse survival than do White men, but it is unclear whether this is because of differences in diagnosis and management. We re-examined these differences in the United Kingdom, where health care is free and unlikely to vary by socioeconomic status. METHODS: This study is a population-based retrospective cohort study of men diagnosed with prostate cancer with data on ethnicity, prognostic factors, and clinical care. A Delphi panel considered the appropriateness of investigations and treatments received. RESULTS: At diagnosis, Black men had similar clinical stage and Gleason scores but higher age-adjusted prostate-specific antigen levels (geometric mean ratio 1.41, 95% confidence interval (95% CI): 1.15-1.73). Black men underwent more investigations and were more likely to undergo radical treatment, although this was largely explained by their younger age. Even after age adjustment, Black men were more likely to undergo a bone scan (odds ratio 1.37, 95% CI: 1.05-1.80). The Delphi analysis did not suggest differential management by ethnicity. CONCLUSIONS: This UK-based study comparing Black men with White men found no evidence of differences in disease characteristics at the time of prostate cancer diagnosis, nor of under-investigation or under-treatment in Black men. British Journal of Cancer (2010) 102, 249-254. doi:10.1038/sj.bjc.6605461 www.bjcancer.com Published online 24 November 2009 (C) 2010 Cancer Research UK
引用
收藏
页码:249 / 254
页数:6
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