Skip to main content
PMC home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 1996 Sep;88(9):589–594.

Radical prostatectomy: lower rates among African-American men.

P J Imperato 1, R P Nenner 1, T O Will 1
PMCID: PMC2608105  PMID: 8855651

Abstract

This study compares radical prostatectomy rates by race among male Medicare patients in New York. A retrospective analysis was conducted of all radical prostatectomies performed on hospitalized male Medicare beneficiaries for the period 1991 through 1993. Basic trend data also were analyzed for 1990. Pattern analysis was conducted on the 4154 procedures performed between 1990 and 1993. The rate of radical prostatectomy rose dramatically during the 3-year period from 1990 to 1992 among New York's 1.1 million male Medicare beneficiaries. The rates rose for both African Americans and whites. However, the annual rates of radical prostatectomy for African Americans were significantly below those for whites. Lower rates of radical prostatectomies were observed for African Americans in all age groups except the < 65-year-old group. However, the total number of radical prostatectomies in this age group were small in number. An important finding was the lower annual rates of radical prostatectomy for African Americans in the 65- to 69-year-old age group. During the period under study, prostate cancer among Medicare patients in New York rose by 33.8% for African Americans and 26.5% for whites. Significantly, local disease was found at the time of diagnosis in 70% of whites but in only 55% of African Americans. These data reflect later stage at diagnosis among African-American males. These results indicate that despite higher national rates for prostate cancer, male African-American Medicare patients in New York have reduced access to radical prostatectomy as a treatment modality. This is especially of importance in the < 70-year-old group in whom most authorities consider the procedure appropriate. The reasons for this reduced access are discussed as are the measures needed to remedy the underlying inequities in health care.

Full text

PDF
589

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Austin J. P., Aziz H., Potters L., Thelmo W., Chen P., Choi K., Brandys M., Macchia R. J., Rotman M. Diminished survival of young blacks with adenocarcinoma of the prostate. Am J Clin Oncol. 1990 Dec;13(6):465–469. doi: 10.1097/00000421-199012000-00002. [DOI] [PubMed] [Google Scholar]
  2. Ayanian J. Z. Race, class, and the quality of medical care. JAMA. 1994 Apr 20;271(15):1207–1208. [PubMed] [Google Scholar]
  3. Ayanian J. Z. Race, class, and the quality of medical care. JAMA. 1994 Apr 20;271(15):1207–1208. [PubMed] [Google Scholar]
  4. Brawn P. N., Johnson E. H., Kuhl D. L., Riggs M. W., Speights V. O., Johnson C. F., 3rd, Pandya P. P., Lind M. L., Bell N. F. Stage at presentation and survival of white and black patients with prostate carcinoma. Cancer. 1993 Apr 15;71(8):2569–2573. doi: 10.1002/1097-0142(19930415)71:8<2569::aid-cncr2820710822>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  5. Catalona W. J. Management of cancer of the prostate. N Engl J Med. 1994 Oct 13;331(15):996–1004. doi: 10.1056/NEJM199410133311507. [DOI] [PubMed] [Google Scholar]
  6. Escarce J. J., Epstein K. R., Colby D. C., Schwartz J. S. Racial differences in the elderly's use of medical procedures and diagnostic tests. Am J Public Health. 1993 Jul;83(7):948–954. doi: 10.2105/ajph.83.7.948. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fincham S. M., Hill G. B., Hanson J., Wijayasinghe C. Epidemiology of prostatic cancer: a case-control study. Prostate. 1990;17(3):189–206. doi: 10.1002/pros.2990170303. [DOI] [PubMed] [Google Scholar]
  8. Johansson J. E., Adami H. O., Andersson S. O., Bergström R., Holmberg L., Krusemo U. B. High 10-year survival rate in patients with early, untreated prostatic cancer. JAMA. 1992 Apr 22;267(16):2191–2196. [PubMed] [Google Scholar]
  9. Lu-Yao G. L., Greenberg E. R. Changes in prostate cancer incidence and treatment in USA. Lancet. 1994 Jan 29;343(8892):251–254. doi: 10.1016/s0140-6736(94)91109-6. [DOI] [PubMed] [Google Scholar]
  10. Lu-Yao G. L., McLerran D., Wasson J., Wennberg J. E. An assessment of radical prostatectomy. Time trends, geographic variation, and outcomes. The Prostate Patient Outcomes Research Team. JAMA. 1993 May 26;269(20):2633–2636. doi: 10.1001/jama.269.20.2633. [DOI] [PubMed] [Google Scholar]
  11. McBean A. M., Gornick M. Differences by race in the rates of procedures performed in hospitals for Medicare beneficiaries. Health Care Financ Rev. 1994 Summer;15(4):77–90. [PMC free article] [PubMed] [Google Scholar]
  12. Mebane C., Gibbs T., Horm J. Current status of prostate cancer in North American black males. J Natl Med Assoc. 1990 Nov;82(11):782–788. [PMC free article] [PubMed] [Google Scholar]
  13. Myers R. E., Wolf T. A., Balshem A. M., Ross E. A., Chodak G. W. Receptivity of African-American men to prostate cancer screening. Urology. 1994 Apr;43(4):480–487. doi: 10.1016/0090-4295(94)90235-6. [DOI] [PubMed] [Google Scholar]
  14. Polednak A. P., Flannery J. T. Black versus white racial differences in clinical stage at diagnosis and treatment of prostatic cancer in Connecticut. Cancer. 1992 Oct 15;70(8):2152–2158. doi: 10.1002/1097-0142(19921015)70:8<2152::aid-cncr2820700824>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  15. Rice T., McCall N. The extent of ownership and the characteristics of Medicare supplemental policies. Inquiry. 1985 Summer;22(2):188–200. [PubMed] [Google Scholar]
  16. Steinberg G. D., Carter B. S., Beaty T. H., Childs B., Walsh P. C. Family history and the risk of prostate cancer. Prostate. 1990;17(4):337–347. doi: 10.1002/pros.2990170409. [DOI] [PubMed] [Google Scholar]
  17. Thompson I. M. Observation alone in the management of localized prostate cancer: the natural history of untreated disease. Urology. 1994 Feb;43(2 Suppl):41–46. doi: 10.1016/0090-4295(94)90217-8. [DOI] [PubMed] [Google Scholar]
  18. Whitmore W. F., Jr Management of clinically localized prostatic cancer. An unresolved problem. JAMA. 1993 May 26;269(20):2676–2677. [PubMed] [Google Scholar]
  19. Whitmore W. F., Jr, Warner J. A., Thompson I. M., Jr Expectant management of localized prostatic cancer. Cancer. 1991 Feb 15;67(4):1091–1096. doi: 10.1002/1097-0142(19910215)67:4<1091::aid-cncr2820670437>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES