African American prostate cancer patients experience longer treatment delays

African American men experience longer prostate cancer treatment delays than Caucasian men, according to a study published online May 28 in Cancer.

“Treatment delay in prostate cancer is associated with increased risk for biochemical recurrence, especially for patients with aggressive (ie, high-risk) disease and is a potentially modifiable factor that may also contribute to racial disparities in prostate cancer,” wrote Ronald Chen, MD, MPH, of the University of North Carolina at Chapel Hill, and colleagues.

Findings were based on Surveillance, Epidemiology and End Results (SEER)-Medicare registry data, and included 2,506 African American and 21,454 Caucasian men diagnosed with non-metastatic prostate cancer from 2004 to 2007. All patients were treated within 12 months of diagnosis.

Results showed that African American patients waited an average of seven days longer for initiation of treatment following diagnosis. The disparity was greater among a subgroup of patients with aggressive prostate cancer, with the average time from diagnosis to surgery or radiotherapy in this group at 96 days for Caucasian patients and 105 days for African American patients.

Chen and colleagues wrote that the clinical significance of a seven-day delay is unclear, but an examination of interquartile ranges of time-to-treatment showed that some patients, even those with aggressive disease, experienced a disparity of 20 days or more. “This difference could plausibly be of clinical importance,” they wrote.

What’s less clear is the role different factors play in delayed treatment and which interventions might eliminate the disparity, which the authors suggested should be the focus of future research.

The authors noted that the Institute of Medicine identified timely delivery of services as one of six goals for improving U.S. healthcare. “Because timely initiation of treatment after cancer diagnosis may be important to maximize long-term disease control and survival outcomes, especially for patients with aggressive cancers, an examination of racial differences in time-to-treatment may allow a better understanding of potentially modifiable causes of the mortality differences seen among [African American] and Caucasian patients with prostate cancer.”