Researchers from the Vanderbilt-Ingram Cancer Center (VICC) at Vanderbilt University have found that black men with prostate cancer receive lower-quality surgical care than white men. Their study found a difference in care due to race even when factors such as age and insurance status were controlled for. The study has been published this month in the Journal of Urology.
The researchers looked at 105,972 cases of prostatectomies in Florida, Maryland, and New York from 1996 to 2007. When patients visited a surgeon or hospital that performs many prostatectomies, they were found to have "better outcomes and lower mortality."
Black men who underwent prostatectomies were 33% less likely to see a surgeon who performs many prostatectomies, and 27% less likely to to visit a hospital that performs a high number of the surgeries. And even though black men who did see surgeons who perform many prostatectomies did have better outcomes overall, they still had worse outcomes than white men in the study.
“Our findings of racial variation in the quality of surgical care for prostate cancer adds to previous studies that have shown racial differences in screening behavior, stage at presentation and use of aggressive treatment, and may contribute to our understanding of why black men have much higher prostate cancer mortality than white men,” said Dr. Daniel Barocas, assistant professor of urologic surgery at Vanderbilt and lead author of the study.
Barocas explains that access to healthcare resources may be a large factor in why black men have worse prostatectomy outcomes than their white counterparts.
“Racial disparities in prostate cancer outcomes may be partially explained by differences in access to high quality care, which in turn may reflect differences in patient resources,” said Barocas. “To close this gap, we may need interventions aimed at improving access to high quality care for all men, including access to high volume health care providers.”