Study reveals racial disparities in prostate cancer treatment
UCLA researchers uncover racial disparities in the prescription rates for hormone therapy in advanced prostate cancer.
A new study led by researchers at UCLA Health Jonsson Comprehensive Cancer Center (CA, USA) has revealed alarming racial disparities in the prescription rates of novel hormone therapy for treatment of advanced prostate cancer. The findings reveal that black men were significantly less likely to receive hormone therapy compared to those who are white or Latino, despite its proven efficacy in controlling the growth of prostate tumors and extending the lives of men with the disease.
This disparity is particularly concerning as black men are already facing a disproportionate impact of prostate cancer and are 1.5 times more likely to be diagnosed and 2.4 times more likely to die from the disease than white men in the United States. The use of novel hormonal therapy agents in this patient population is not fully elucidated, especially in regards to equitable access to treatment across difference race and ethnicity groups. Thus, given this context, the need for population-based studies is particularly important.
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Early in cancer cell development, androgens, such as testosterone, play a key role in the growth and progression of prostate cancer cells. Hormonal therapy agents target the androgen signalling axis by directly inhibiting the androgen receptor or reducing the level of androgens in the body. Often used in conjunction with traditional androgen deprivation therapy helps to more effectively suppress androgen signalling, offering improved outcomes for patients with advanced or metastatic prostate cancer.
The study, co-authored by Amar Kishan (UCLA Health), investigated how doctors prescribe hormonal therapy drugs based on the race and ethnicity of patients in the US between 2011−2017 in a Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database. The study included 3748 men of which 8% were black, 7% hispanic, 78% white and 7% from other racial and ethnic groups. The majority of patients had metastatic prostate cancer, with 36% receiving novel hormone therapy.
White patients had the highest 2-year novel hormone therapy utilization rate at 27%, followed by Hispanic patients at 25%, and other racial/ethnic groups at 23%. In contrast, black patients had the lowest rate at 20%, a disparity that persisted at 5 years and beyond.
Co-senior author of the study Michael Xiang, from David Geffen School of Medicine at UCLA highlighted the need for future studies to uncover the reasons behind this inequality, “our findings raise critical questions regarding the reasons behind this inequality, suggesting possible obstacles to healthcare, financial burdens, and unconscious biases within the healthcare system”.
Overall, these findings underscore the urgent need to systematically address healthcare disparities and promote equitable access to life-saving treatments for all individuals, regardless of their racial or ethnic background. It is hoped that further research can provide new understanding as well as address the social determinants of hormonal therapy prescription.
Source: www.uclahealth.org/news/black-men-with-advanced-prostate-cancer-less-likely-receive
