Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
J Immigr Minor Health. 2013 Aug;15(4):803-9. doi: 10.1007/s10903-012-9662-y.
Prostate cancer is the most common cancer among men in the United States with striking differences in incidence and mortality among ethnic groups. Michigan has one of the largest concentrations of Arab Americans (AAs) in the U.S. and little is known about this ethnic minority with respect to prostate cancer. This study investigated differences in clinical profile, quality of care, and recurrence among prostate cancer survivors comparing AAs and Caucasian Americans (CAs). Participants in this study included 2499 prostate cancer survivors from the Michigan Cancer Registry from 1985 to 2004. Participants completed surveys regarding health-seeking behavior, post-treatment symptoms, quality of care and recurrence. Ethnicity was self-reported and AAs and CAs were compared with respect to clinical profile, quality of care, and recurrence. There were 52 AAs and 1886 CAs patients with AAs being younger ([Formula: see text] age 68.3 ± SD 21.4 years, [Formula: see text] age 72.3 ± SD 14.1 years, for AAs and CAs, respectively) (P = 0.05). AAs had lower socioeconomic standard than CAs (34 vs. 10.6 %, <$20,000 yearly income/year; for AAs vs. CAs, respectively) (P < 0.0001). AAs reported poorer health than AAs (7.7 vs. 3.0 % for AAs vs. CAs, respectively) (P < 0.0001). AAs were more likely to visit specialists for prostate follow-up (44.5 vs. 19.7 % visited a specialist, for AAs vs. CAs respectively) (P < 0.0001) and received supplementary healthcare workers (13 % of AAs vs. 3.1 % CAs) (P = 0.032). In addition, AAs reported higher occurrence of urinary incontinence compared to CAs (67.4 vs. 60.4 %, for AAs vs. CAs, respectively) (P = 0.001). Ethnic background was not a predictor of recurrence [(Odds ratio (OR) = 1.1 (95 % confidence intervals CI = 0.40, 2.9)] (P = 0.873) even after adjusting for age, PSA levels within the last 2 years, metastasis and hormonal therapy. While AAs prostate cancer patients were different from CAs in age, income, seeking medical care, and health reporting, ethnic background was not a predictor of recurrence. Future studies of the impact of socioeconomic, demographic and cultural factors, and health care seeking behavior on long-term survival of prostate cancer in AAs and other ethnic minorities are warranted.
前列腺癌是美国男性中最常见的癌症，不同种族之间的发病率和死亡率存在显著差异。密歇根州拥有美国最大的阿拉伯裔美国人（AA）聚居地之一，对于这个少数族裔的前列腺癌情况知之甚少。本研究旨在调查比较 AA 和白种美国人（CA）前列腺癌幸存者之间在临床特征、护理质量和复发方面的差异。本研究的参与者包括来自密歇根癌症登记处 1985 年至 2004 年的 2499 名前列腺癌幸存者。参与者完成了关于寻医行为、治疗后症状、护理质量和复发的调查。种族是自我报告的，AA 和 CA 之间就临床特征、护理质量和复发进行了比较。有 52 名 AA 和 1886 名 CA 患者，AA 组年龄较小（[公式：见正文]岁 68.3 ± SD 21.4 岁，[公式：见正文]岁 72.3 ± SD 14.1 岁，AA 和 CA 分别）（P = 0.05）。AA 的社会经济地位低于 CA（34%比 10.6%，年收入<$20,000/年；分别为 AA 和 CA）（P < 0.0001）。AA 报告的健康状况比 CA 差（AA 为 7.7%，CA 为 3.0%，分别为 AA 和 CA）（P < 0.0001）。AA 更有可能为前列腺随访而看专科医生（分别为 44.5%和 19.7%的 AA 和 CA 看了专科医生）（P < 0.0001），并接受了补充医疗保健工作者（分别为 13%的 AA 和 3.1%的 CA）（P = 0.032）。此外，AA 报告尿失禁的发生率高于 CA（AA 为 67.4%，CA 为 60.4%，分别为 AA 和 CA）（P = 0.001）。即使在调整了年龄、过去 2 年内 PSA 水平、转移和激素治疗后，种族背景也不是复发的预测因素[（优势比（OR）= 1.1（95%置信区间（CI）= 0.40，2.9）]（P = 0.873）。尽管 AA 前列腺癌患者在年龄、收入、就医和健康报告方面与 CA 不同，但种族背景并不是复发的预测因素。需要进一步研究社会经济、人口和文化因素以及医疗保健寻求行为对 AA 和其他少数族裔前列腺癌长期生存的影响。
