presents the distribution of patient demographic and tumor characteristics for Asian, Hispanic, black, and white men who were diagnosed with prostate cancer between 1995 and 2002. There were significant differences when comparing these groups. Black men were diagnosed with prostate cancer an average age of 1 year earlier than white men. Black, Asian, and Hispanic men were more likely to be diagnosed at a regional or distant stage compared with white men, and black men were more likely to be have an unknown stage of disease at diagnosis. Compared with white men, black and Asian men were less likely and Hispanic men were more likely to have well-differentiated tumors. Furthermore, there were statistically significant differences with regard to SES and rural residence when comparing white men with Asian, black, and Hispanic men. Significantly higher percentages of black (32.4%) and Hispanic men (34.1%) resided in very low socioeconomic areas compared with 7.9% of white men, whereas a greater percentage of Asian men (43.8%) resided in very high socioeconomic areas compared with white men (35.5 %). Although the majority of all men resided in urban areas, Hispanic and black men were less likely than white men to live in rural areas of small towns.
Demographic and tumor characteristics of men diagnosed with prostate cancer in Texas from 1995–2002, by race/ethnicity (percent)
presents the unadjusted all-cause and prostate cancer-specific probability of surviving ≥5 years by race/ethnicity and SES. Overall, survival was greatest for Asian men and lowest for black men. The probability of surviving 5 years independent of the cause of death was 79% for white men, 70% for black men, 74% for Hispanic men, and 86% for Asian men. Prostate-specific survival probabilities followed a similar pattern by race: 92% for white men, 83% for black men, 88% for Hispanic men, and 94% for Asian men. Those who resided in neighborhoods of very low SES had poorer survival (70% all-cause survival) compared with those who lived in areas with very high SES (83%). Similarly, prostate cancer 5-year survival probabilities ranged from 85% for those residing in very low SES areas to 94% for those residing in very high SES areas.
Unadjusted probability of surviving 5 or more years for men diagnosed with prostate cancer from 1995–1998, by race/ethnicity or socioeconomic status (SES)
compares the mortality associated with race/ethnicity in men diagnosed with prostate cancer by stage at diagnosis during the years 1995 through 2002. After adjusting for SES, age, tumor stage, tumor grade, rural residence, and year of diagnosis, black men were more likely to die (adjusted hazard ratio [aHR], 1.36; 95% confidence interval [95% CI], 1.30–1.42) and Asian men were less likely to die (aHR, 0.65; 95% CI, 0.52–0.82) compared with white men. For black men, the same trend was evident when their cancer was diagnosed at either a local, regional/distant, or unknown stage (aHR, 1.28 [95% CI, 1.19–1.36]; aHR, 1.49 [95% CI, 1.37–1.63]; and aHR, 1.35 [95% CI, 1.25–1.46], respectively.) Asian men were less likely than white men to die when their cancer was diagnosed at a local stage (aHR, 0.49; 95% CI, 0.33–0.73).
Mortality associated with race/ethnicity in men with prostate carcinoma by SEER Summary stage at diagnosis, 1995–2002
With regard to overall prostate-specific mortality, compared with white men, black (aHR, 1.70; 95% CI, 1.58–1.83) and Hispanic men (aHR, 1.11; 95% CI, 1.02–1.20) were more likely to die of prostate cancer (). Of those diagnosed at a local stage of disease, black and Hispanic men were more likely to die compared with white men (aHR, 1.52 [95% CI, 1.30–1.78] and aHR, 1.23 [95% CI, 1.05–1.44], respectively). Black men were also more likely than white men to die when diagnosed at regional/distant and unknown stages (aHR, 1.70 [95% CI, 1.52–1.89] vs. aHR, 1.80 [95% CI, 1.57–2.05], respectively).
Prostate cancer-specific mortality associated with race/ethnicity in men with prostate carcinoma by SEER Summary stage at diagnosis, 1995–2002
shows predictors of prostate-specific mortality. Black men had a significantly higher risk of dying (HR, 2.01; 95% CI, 1.89–2.17) compared with white men in the unadjusted model. However, this risk was reduced after full adjustment for age, year of diagnosis, tumor stage, tumor grade, SES, and urban/rural residence (HR, 1.70; 95% CI, 1.58–1.83). For Hispanic men, the risk of death was higher than that for white men (HR, 1.55; 95% CI, 1.43–1.67) in the crude model. However, after full adjustment, their risk decreased but remained higher than that of white men (HR, 1.11; 95% CI, 1.02–1.20).
Analysis of predictors of prostate cancer specific mortality for men diagnosed with prostate carcinoma, 1995–2002
Finally, to ensure similar follow-up time after diagnosis, we restricted the analysis to men diagnosed between 1995 and 1998 and followed through 2003. The results for overall and stage-specific all-cause mortality and prostate cancer-specific mortality were very similar to the rates for men diagnosed from 1995 through 2002 (), and therefore are not presented.