In this study to identify gaps in prostate cancer care quality, racial disparities in care, and underlying reasons for poorer quality care.Black men are more likely to die as a result of prostate cancer than white men, despite effective treatments that improve survival for clinically significant prostate cancer. We identified all black men and random age-matched white men with Gleason scores ≥ 7 diagnosed between 2006 and 2013 at two urban hospitals to determine rates of treatment underuse. Underuse was defined as not receiving primary surgery, cryotherapy, or radiotherapy.
Of 359 black and 282 white men, only 25 (4%) experienced treatment underuse, and 23 (92%) of these were black. Most (78%) cases of underuse were due to system failures, where treatment was recommended but not received; 38% of these men continued receiving care at the hospitals. All men with treatment underuse due to system failures were black.
We wished to include quality measures of RT dosing and ADT timing, but there was inadequate documentation to reliably assess these measures. Men with intermediate-risk cancer and low life expectancy who received active surveillance, defined as semiannual prostate-specific antigen (PSA) testing, were not considered as underuse. Life expectancy was determined using the Schonberg prognostic index.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5765902/
