title: Racial/ethnic differences in the relative risk of receipt of specific treatment among men with prostate cancer.
abstract: African-American (AA) men have excess mortality from prostate cancer compared with White men, which has remained unchanged over several decades. The purpose of this study is to determine if race/ethnicity is an independent predictor of receipt of any definitive treatment vs. watchful waiting/active surveillance (WW/AS).
  
  
  
  Men diagnosed with prostate cancer from 2004 to 2011 were identified from the Surveillance, Epidemiology, and End-Results program. Multinomial logistic regression analysis was performed to determine the relative risk ratio (RRR) of receipt of radical prostatectomy (RP), external beam radiation therapy (RT), brachytherapy, cryotherapy, or combination therapy vs. WW/AS.
  
  
  
  Compared with White men, AA men were significantly less likely to receive RP (RRR = 0.53, P<0.001), brachytherapy (RRR = 0.72, P<0.001), cryotherapy (RRR = 0.84, P = 0.001), and combination therapy (RRR = 0.70, P<0.001), and more likely to receive RT (RRR = 1.03, P = 0.041) vs. AS/WW. Hispanic men were significantly less likely to receive RP (RRR = 0.84, P<0.001) and brachytherapy (RRR = 0.77, P<0.001), and more likely to receive RT (RRR = 1.08, P<0.001), and cryotherapy (RRR = 1.19, P = 0.005) vs. AS/WW compared with White men.
  
  
  
  The disparate risk of receiving definitive treatment among AA and Hispanic men represents a significant public health issue that requires efforts to improve physician education, increase cultural competency, and ensure equitable access.
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN. Electronic address: kelvin.a.moses@vanderbilt.edu.
authors.forename: Kelvin A
authors.initials: KA
authors.lastname: Moses
authors.affiliation: Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY.
authors.forename: Heather
authors.initials: H
authors.lastname: Orom
authors.affiliation: Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY.
authors.forename: Alicia
authors.initials: A
authors.lastname: Brasel
authors.affiliation: Loyola University Chicago Stritch School of Medicine, Chicago, IL.
authors.forename: Jacquelyne
authors.initials: J
authors.lastname: Gaddy
authors.affiliation: Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY; Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Willie
authors.initials: W
authors.lastname: Underwood
mesh_terms: D000368:Aged; D001918:Brachytherapy; D005006:Ethnicity; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000628:therapy*; D044469:Racial Groups; D018570:Risk Assessment; D018426:SEER Program; D044465:White People
keywords: Prostate cancer; Racial disparity; Treatment