Black men with advanced prostate cancer less likely to receive crucial treatment, study finds

A new study led by researchers at UCLA Health Jonsson Comprehensive Cancer Center found that black men diagnosed with more advanced stages of prostate cancer are significantly less likely to be prescribed new hormone therapy than other racial and ethnic groups , including white or Latino men, despite the fact that this therapy has been proven to effectively control the growth of prostate tumors and prolong the lives of men with the disease.

The results, published in Open JAMA Networkreveal a concerning racial disparity in the use of the therapy crucial to treating the disease.

“This revelation is particularly concerning given the already disproportionate impact of prostate cancer on black men, who are 1.5 times more likely to be diagnosed and 2.4 times more likely to die from the disease than men. white men in the United States,” said study co-senior author Dr. Amar Kishan, professor of radiation oncology at the David Geffen School of Medicine at UCLA and investigator at the UCLA Health Jonsson Comprehensive Cancer Center .

Novel hormone therapy agents represent the next generation of hormone therapy targeting the androgen signaling axis, which plays a crucial role in the growth and progression of prostate cancer cells. Androgens, like testosterone, stimulate the growth of prostate cancer. Hormone therapy works by inhibiting the action of androgens or reducing their levels in the body.

They are also often used in combination with traditional androgen deprivation therapy to more effectively suppress androgen signaling, providing better outcomes for patients with advanced or metastatic prostate cancer.

“Although we know that hormonal therapies have significant clinical benefits in men with more advanced prostate cancer, there is not much information available on how often people in the general population use these medicines, particularly in the context of equitable access to these medicines across the world. different racial and ethnic groups,” said Dr. Michael Xiang, assistant clinical professor of radiation oncology at the David Geffen School of Medicine at UCLA and co-senior author of the study.

To examine how doctors prescribe these drugs based on patients’ race and ethnicity in the United States, the team of researchers used data from a population-based cancer registry linked to patient records. prescription medications from 3,748 Medicare beneficiaries with a median age of 75 years and a median age of 75 years. diagnosis of advanced prostate cancer from 2011 to 2017. Of these, 8% were black, 7% Hispanic, 78% white, and 7% from other racial and ethnic groups.

The majority of patients had metastatic prostate cancer, with 36% receiving new hormone therapy. White patients had the highest two-year rate of new hormone therapy use at 27%, followed by Hispanic patients at 25% and other racial/ethnic groups at 23%. Black patients had the lowest rate at 20%.

This disparity persisted beyond five years, with black patients consistently receiving this crucial treatment at a lower rate than their white counterparts. Researchers found that black men were 24% less likely to receive or be prescribed one of these new hormone therapy agents compared to white men. In contrast, this disparity was not observed among Latino men or men from other racial and ethnic groups.

“Our findings raise critical questions regarding the reasons for this inequality, suggesting possible healthcare barriers, financial burdens, and unconscious bias within the healthcare system,” Xiang said.

Future studies are needed to uncover underlying causes and systematically address these issues for more equitable care, the authors noted.

The study’s first author is Dr. Ting Martin Ma, a former radiation oncology resident at the David Geffen School of Medicine at UCLA and currently an assistant professor of radiation oncology at the University of Washington. Other UCLA authors include: Dr. Matthew Rettig, Dr. Luca Valle, Dr. Michael Steinberg, and Dr. Isla Garraway.