Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Am J Mens Health. 2020 Nov-Dec;14(6):1557988320984282. doi: 10.1177/1557988320984282.
Surgical prostate cancer (PCa) treatment delay (TD) may increase the likelihood of recurrence of disease, and influence quality of life as well as survival disparities between Black and White men. We used latent class analysis (LCA) to identify risk profiles in localized, malignant PCa surgical treatment delays while assessing co-occurring social determinants of health. Profiles were identified by age, marital status, race, county of residence (non-Appalachian or Appalachian), and health insurance type (none/self-pay, public, or private) reported in the Tennessee Department of Health cancer registry from 2005 to 2015 for adults ≥18 years ( = 18,088). We identified three risk profiles. The highest surgical delay profile (11% of the sample) with a 30% likelihood of delaying surgery >90 days were young Black men, <55 years old, living in a non-Appalachian county, and single/never married, with a high probability of having private health insurance. The medium surgical delay profile (46% of the sample) with a 21% likelihood of delay were 55-69 years old, White, married, and having private health insurance. The lowest surgical delay profile (42% of the sample) with a 14% likelihood of delay were ≥70 years with public health insurance as well as had a high probability of being White and married. We identified that even with health insurance coverage, Blacks living in non-Appalachian counties had the highest surgical delay, which was almost double that of Whites in the lowest delay profile. These disparities in PCa surgical delay may explain differences in health outcomes in Blacks who are most at-risk.
前列腺癌（PCa）的手术治疗延迟（TD）可能会增加疾病复发的可能性，并影响黑人和白人男性的生活质量和生存差异。我们使用潜在类别分析（LCA）来识别局部恶性 PCa 手术治疗延迟的风险特征，同时评估健康的社会决定因素的共同发生。通过在 2005 年至 2015 年期间在田纳西州卫生部癌症登记处报告的年龄、婚姻状况、种族、居住县（非阿巴拉契亚或阿巴拉契亚）和健康保险类型（无/自付、公共或私人）来识别特征，这些特征适用于≥18 岁的成年人（=18088 人）。我们确定了三个风险特征。最高手术延迟特征（样本的 11%）有 30%的可能性将手术延迟>90 天，这些患者是年轻的黑人男性，<55 岁，居住在非阿巴拉契亚县，单身/从未结婚，并且极有可能拥有私人健康保险。中等手术延迟特征（样本的 46%）有 21%的延迟可能性，这些患者年龄在 55-69 岁，白人，已婚，并且拥有私人健康保险。最低手术延迟特征（样本的 42%）有 14%的延迟可能性，这些患者年龄≥70 岁，拥有公共健康保险，并且极有可能是白人且已婚。我们发现，即使有健康保险覆盖，居住在非阿巴拉契亚县的黑人的手术延迟率最高，几乎是最低延迟特征中白人的两倍。这些在 PCa 手术延迟方面的差异可能解释了最易受影响的黑人在健康结果方面的差异。
