Brawn P N, Johnson E H, Kuhl D L, Riggs M W, Speights V O, Johnson C F, Pandya P P, Lind M L, Bell N F
Department of Pathology, Veterans Administration Medical Center, Ann Arbor 48105.
Cancer. 1993 Apr 15;71(8):2569-73. doi: 10.1002/1097-0142(19930415)71:8<2569::aid-cncr2820710822>3.0.co;2-r.
Black men are known to have a higher incidence and mortality from prostate carcinoma than white men and are more likely to have a more advanced stage or grade of disease diagnosed.
In a Veterans Administration Medical Center where black and white men have the same eligibility for medical care, the authors reviewed the stage at presentation of 861 consecutive cases of prostate carcinoma diagnosed from 1969-1990. In addition, survival, stratified by race, stage, and grade, was determined on all men in whom prostate cancer was diagnosed from 1969-1985 (525 patients).
It was found that 26% of white and 52% of black men with prostate carcinoma presented with Stage D disease. Similar proportions of white and black men with prostate carcinoma presented with Stage D disease between 1969-73 as between 1986-90. The overall survival was poorer for black men because of their higher proportion of Stage D disease, but stratified for grade and stage, survival was similar in both races.
This study suggests that factors other than eligibility for medical care may be responsible for the higher proportion of black men with prostate carcinoma presenting with Stage D prostate carcinoma.
众所周知，黑人男性前列腺癌的发病率和死亡率高于白人男性，且更有可能被诊断为疾病处于更晚期或更高分级。
在一家退伍军人管理局医疗中心，黑人和白人男性享有相同的医疗资格，作者回顾了1969年至1990年连续诊断的861例前列腺癌病例的就诊时分期。此外，还确定了1969年至1985年期间所有被诊断为前列腺癌的男性（525例患者）按种族、分期和分级分层的生存率。
发现患有前列腺癌的白人男性中有26%、黑人男性中有52%就诊时为D期疾病。1969年至1973年期间与1986年至1990年期间，患有前列腺癌的白人男性和黑人男性中就诊时为D期疾病的比例相似。黑人男性的总体生存率较差，因为他们D期疾病的比例较高，但按分级和分期分层后，两个种族的生存率相似。
本研究表明，除医疗资格外的其他因素可能是患有前列腺癌的黑人男性中就诊时为D期前列腺癌比例较高的原因。
