Prostate cancer is a cancer type associated with a high level of racial and socioeconomic disparities as reported by many previous studies. However, the changes in these disparities in the past two decades have not been systematically studied. In this study, we investigated the Surveillance Epidemiology End Results (SEER) data for prostate cancer patients diagnosed during 2004–2018. African Americans and Asians showed significantly better and worse cancer-specific survival (CSS), respectively, compared to non-Hispanic white individuals after adjusting for confounding factors such as age and cancer stage. Importantly, the data indicated that racial disparities fluctuated and reached the highest level during 2009–2013, and thereafter, it showed a substantial improvement. Such a change cannot be explained by the improvement in early diagnosis but is mainly driven by the differential improvement in CSS between races. Compared with Asians and non-Hispanic whites, African American patients achieved a more significant survival improvement during 2014–2018, while no significant improvement was observed for Hispanics. In addition, the SEER data showed that high-income patients had significantly longer CSS than low-income patients. Such a socioeconomic disparity was continuously increasing during 2004–2018, which was caused by the increased survival benefits of the high-income patients with respect to the low-income patients. Our study suggests that more efforts and resources should be allocated to improve the treatment of patients with low socioeconomic status.
既往多项研究表明，前列腺癌是一种存在显著种族和社会经济差异的癌症类型。但过去二十年间这些差异的变化尚未得到系统研究。本研究分析了2004-2018年间确诊的前列腺癌患者监测流行病学最终结果（SEER）数据。在调整年龄和癌症分期等混杂因素后，与非西班牙裔白人相比，非洲裔患者癌症特异性生存期显著更优，而亚裔患者则显著更差。值得注意的是，数据显示种族差异在2009-2013年间波动并达到峰值，此后出现实质性改善。这种变化无法用早期诊断的改进来解释，而主要由不同种族间癌症特异性生存期的差异化改善所驱动。与亚裔和非西班牙裔白人相比，非洲裔患者在2014-2018年间取得了更显著的生存期改善，而西班牙裔患者则未见明显改善。此外，SEER数据显示高收入患者的癌症特异性生存期显著长于低收入患者。这种社会经济差异在2004-2018年间持续扩大，主要是由高收入患者相较于低收入患者的生存获益增加所致。本研究提示，应投入更多精力和资源改善低社会经济地位患者的治疗方案。
Reduced Racial Disparity as a Result of Survival Improvement in Prostate Cancer
肿瘤(癌症)患者之家