Tinsley Shane A, Stephens Alex, Morrison Chase, Richard Caleb, Hares Keinnan, Lutchka Jonathan, Rogers Craig, Abdollah Firas
Vattikuti Urology Institute, Henry Ford Health, 2799 W Grand Blvd, Detroit, MI, 48202, USA.
Public Health Sciences, Henry Ford Health, Detroit, MI, USA.
J Racial Ethn Health Disparities. 2025 Mar 6. doi: 10.1007/s40615-025-02350-8.
To assess the utilization and prostate cancer (PCa)-specific mortality (PCSM) between non-Hispanic Black (NHB) and non-Hispanic White (NHW) on active surveillance (AS) with intermediate risk PCa (iPCa).
The Surveillance, Epidemiology, and End Results database was queried between 2010-2016. The rate of AS was calculated per year between NHB and NHW using univariable logistic analysis (UVA) and multivariable logistic analysis (MVA). Next, inverse probability of treatment weighting was performed on those that underwent watchful waiting (WW) and competing-risks cumulative incidence function (CIF) and MVA were used to assess the impact of race on other-cause mortality (OCM) and PCSM. Statistical significance defined as p < 0.05, but some observations were deemed non-statistically significant per our Benjamini-Hochberg procedures, RESULTS: 50,315 patients had iPCa, and 3,310 underwent AS/WW. The rate of AS increased amongst NHB (+ 3.1%) and NHW (+ 5.7%) from 2010 - 2016. UVA did not show an association with race, but MVA showed a negative association, based on our Benjamini-Hochberg correction, between NHB and AS [OR 0.68 (95% CI: 5.4-0.87; p = 0.002)]. On CIF, NHB and NHW had non-significant differences in OCM in the weighted cohort (p = 0.03), due to the Benjamini-Hochberg correction, and that was confirmed with MVA with a HR of 1.23 (95% CI: 1.02-1.49; p = 0.03). However, the CIF on PCSM showed NHB had a higher risk of PCSM (p < 0.0001), and that was confirmed with MVA with a HR of 3.01 (95% CI: 2.00-4.53; p < 0.001).
The utilization of AS for iPCa increased amongst NHB and NHW patients. Unfortunately, NHB race was associated with increased risk of PCSM from one year to the next compared to NHW patients.
评估非西班牙裔黑人（NHB）和非西班牙裔白人（NHW）在对中危前列腺癌（iPCa）进行主动监测（AS）时的使用情况以及前列腺癌（PCa）特异性死亡率（PCSM）。
查询2010 - 2016年间的监测、流行病学和最终结果数据库。使用单变量逻辑回归分析（UVA）和多变量逻辑回归分析（MVA）计算NHB和NHW每年的AS率。接下来，对接受观察等待（WW）的患者进行治疗权重的逆概率分析，并使用竞争风险累积发病率函数（CIF）和MVA来评估种族对其他原因死亡率（OCM）和PCSM的影响。统计学显著性定义为p < 0.05，但根据我们的Benjamini - Hochberg程序，一些观察结果被认为无统计学显著性。结果：50,315例患者患有iPCa，3,310例接受了AS/WW。2010年至2016年期间，NHB（+3.1%）和NHW（+5.7%）的AS率均有所上升。UVA未显示与种族有关联，但根据我们的Benjamini - Hochberg校正，MVA显示NHB与AS之间存在负相关[比值比（OR）0.68（95%置信区间：5.4 - 0.87；p = 0.002）]。在CIF分析中，由于Benjamini - Hochberg校正，加权队列中NHB和NHW在OCM方面无显著差异（p = 0.03），MVA也证实了这一点，风险比（HR）为1.23（95%置信区间：1.02 - 1.49；p = 0.03）。然而，PCSM的CIF显示NHB的PCSM风险更高（p < 0.0001），MVA也证实了这一点，HR为3.01（95%置信区间：2.00 - 4.53；p < 0.001）。
NHB和NHW患者中iPCa的AS使用率有所增加。不幸的是，与NHW患者相比，NHB种族在次年发生PCSM的风险增加。
