Latin-American PCa patients less likely to receive definitive treatment
Latin-American men are less likely than non-Latin-American Caucasian men to receive guideline-recommended definitive treatment for high-risk localized prostate cancer, according to a recent study.
Latin-American men are less likely than non-Latin-American Caucasian men to receive guideline-recommended definitive treatment for high-risk localized
All men with high-risk localized prostate cancer and a life expectancy of greater than 5 years should receive definitive therapy, according to National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Yet, in this study of 2,421 Latin-American and 8,636 non-Latin-American Caucasian men with high-risk localized disease in the California Cancer Registry (2010 to 2014), Latin-Americans were 21% less likely to receive recommended treatment.
The authors eliminated the disparity after adjusting for sociodemographic factors, finding that Latin-Americans’ prostate cancer treatment seemed impacted by several sociodemographic and other nonclinical factors, including neighborhood socioeconomic status, health insurance, marital status, and care at a National Cancer Institute (NCI)]-designated cancer center, according to the study’s lead author Daphne Lichtensztajn, MD, MPH, of the University of California, San Francisco department of epidemiology and biostatistics.
Having health insurance, for example, was a factor in whether Caucasians and Latin-Americans received definitive care, but it was a much bigger factor among Latin-American men. While uninsured non-Latin-American Caucasian men were 37% less likely to receive definitive treatment than non-Latin-American Caucasians with insurance, uninsured Latin-Americans were 66% less likely to undergo definitive treatment compared to Latin-Americans with health insurance.
“While we expected to find an association between lack of insurance and under-treatment, the difference in the magnitude of this effect between Latinos and non-Latinos was surprising,” Dr. Lichtensztajn said.
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The authors also found that non-Latin-American Caucasian men with high-risk localized prostate cancer were 57% more likely to receive recommended treatment if they went to an NCI-designated cancer center. There was no such increase in the odds of receiving definitive treatment for Latin-American men seeking care at these cancer centers.
That, too, was surprising, according to Dr. Lichtensztajn.
“NCI-designated cancer centers are generally associated with higher quality of care and greater availability of ancillary services, such as patient navigators and translators, which would have been expected to result in a greater likelihood of receiving definitive treatment, as it did for the non-Latino men,” she said.
Latin-Americans make up the nation’s largest minority group. The disparity in high-risk localized prostate cancer care is a multifaceted issue that will require efforts at various levels in health care, according to Dr. Lichtensztajn.
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