According to the results of a study presented at the 2007 annual meeting of the American Association for Cancer Research (AACR), African-American men have a higher rate of prostate cancer recurrence than White men even after accounting for two important measures of the care-hospital volume and physician volume.
Prostate cancer accounts for 37% of all cancers diagnosed in African-American men. African-American men are more likely to develop prostate cancer than White men, and are also more than twice as likely to die of the disease. These disparities could be due to a variety of factors, ranging from access to care to tumor biology.
For several types of cancer, a large and growing body of evidence has demonstrated improved outcomes for patients treated by surgeons who perform a high volume of specialized surgeries and for patients who are treated in a hospital with a high volume of patients undergoing a specific procedure.
In order to explore the extent to which hospital volume and physician volume explain racial differences in prostate cancer recurrence, researchers conducted a study among 962 African-American men and 7,387 White men who had undergone surgery for prostate cancer between 1993 and 1999. The researchers accounted for differences across study subjects in age, cancer stage, and cancer grade (Gleason score).
- As expected, the study found that treatment at a high-volume hospital was linked with a lower rate of cancer recurrence.
- After accounting for hospital volume, racial differences in prostate cancer persisted. Even among men treated at high-volume hospitals, African-American men had worse prostate cancer outcomes than White men.
This persistence of racial disparities was unexpected. In a prepared statement, Dr. Kyna Gooden, one of the authors of the study, said, “We expected that if everyone was treated by similarly experienced doctors or hospitals, they would have had comparable outcomes. But that wasn’t the case.” She further noted, “These results may have less to do with access to clinical care but more to do with lifestyle factors and the physical and genetic characteristics of the tumor itself.”
 Gooden KM, Howard DL, Carpenter WR, Carson AP, Jallah YB, Godley PA. The effect of hospital and physician volume on racial differences in disease recurrence following surgery for prostate cancer. Presented at the 2007 meeting of the American Association for Cancer Research, Los Angeles, CA, April 14-18, 2007. Abstract 3416.