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Social determinants of health affect racial disparity in prostate cancer mortality
When accounting for social determinants of health (SDOH), Black men with prostate cancer have lower prostate cancer-specific mortality (PCSM) than White men, according to a systematic review and meta-analysis published online Jan. 11 in JAMA Network Open.
Randy A. Vince Jr., M.D., from the University Hospitals Seidman Cancer Center at Case Western Reserve University in Cleveland, and colleagues examined the association of SDOH with PCSM and overall survival among Black and White patients. Data were reviewed from 47 studies with 1,019,908 patients (176,028 Black men and 843,880 White men) who were followed for a median of 66.0 months.
The researchers found that for Black versus White men, there was no significant difference in PCSM or overall survival. A significant race-SDOH interaction was seen for both PCSM and overall survival (regression coefficient, −0.041 and −0.017, respectively). Black patients had significantly higher PCSM than White patients in studies with minimal accounting for SDOH (<5-point score) (hazard ratio, 1.29). PCSM was significantly lower among Black versus White patients in studies with greater accounting for SDOH variables (≥10-point score) (hazard ratio, 0.86).
"These results underscore the importance of accounting for SDOH in racial disparity research," the authors write. "Addressing inequities in SDOH represents modifiable social factors that require attention to reduce the long-standing disparity in prostate cancer health outcomes."
Several authors disclosed financial ties to the biopharmaceutical and other industries.
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