title: African-American Men with Low-Risk Prostate Cancer: Modern Treatment and Outcome Trends.
abstract: OBJECTIVE
  To investigate the clinical characteristics and treatment patterns for African-American (AA) men with low-risk prostate cancer (PCa) using a national, population-based dataset.
  
  
  METHODS
  We conducted a retrospective review of the Surveillance Epidemiology and End Results database 2004-2008. AA men aged ≥40 years with low-risk PCa were identified. For comparison, white men were selected using the same selection criteria. We reviewed all recorded treatment modalities. Definitive treatment (DT) was defined as undergoing radiotherapy or prostatectomy.
  
  
  RESULTS
  Overall, 7246 AA men and 47,154 white men met the criteria. Most of the patients had PSA level between 4.1 and 6.9 ng/mL (56.2 %) and received DT (76 %). Black men were younger (mean age: 62(±8) vs. 65(±10) years), less likely to receive DT (adjusted odds ratio (AOR), 0.71 [0.67-0.76]), and of those receiving DT, less likely to undergo prostatectomy (AOR, 0.58 [0.54-0.62]). Patients receiving DT had lower crude cancer-specific and overall mortality (0.17 vs. 0.41 % and 2.9 vs. 7.8 %, p value < 0.001, respectively, among blacks). The difference in overall mortality was largest among ≥ 75 years (5.6 vs. 18.2 %). Across age groups, blacks had higher all-cause mortality (AOR, 1.45 [1.13-1.87] and 1.56[1.31-1.86] for <65 and ≥ 65 years, respectively).
  
  
  CONCLUSIONS
  Our study of a large modern cohort of men with low-risk PCa demonstrates significant lower receipt of DT, lower receipt of prostatectomy among those receiving DT, and lower survival for black men compared to their white counterparts. Older men were less likely to receive DT. Patients who received DT had better survival. The survival difference was most striking among the elderly.
authors: Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
authors: Augustine C
authors: AC
authors: Obirieze
authors: Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
authors: Ambria
authors: A
authors: Moten
authors: Department of Surgery, Howard University Hospital, Washington, DC, USA.
authors: Delenya
authors: D
authors: Allen
authors: Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, DC, USA. cahaghotu@howard.edu.|Department of Surgery, Howard University Hospital, Washington, DC, USA. cahaghotu@howard.edu.|Division of Urology, Department of Surgery, Howard University College of Medicine and Howard University Hospital, Washington, DC, USA. cahaghotu@howard.edu.|Howard University Hospital, 2041 Georgia Ave, NW, Room 4C02, Washington, DC, 20060, USA. cahaghotu@howard.edu.
authors: Chiledum A
authors: CA
authors: Ahaghotu
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D016208:Databases, Factual; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: African-American; Definitive treatment; Low-risk prostrate cancer; Outcomes