Retrospective, population-based study of racial differences in secondary treatment pathways and survival in localized prostate cancer

Black men are more than 2 times more likely to die of prostate cancer than White men. A retrospective, population based cohort study using SEER-Medicare data assessed differences in treatment trajectories after primary treatment and their associations with mortality outcomes comparing Black and White patients with localized prostate cancer. The study included patients aged 66 years and older enrolled in Medicare and diagnosed between 2004 and 2017, after primary treatment (surgery or radiation therapy). In this cohort study of 83 156 patients, Black and White patients received secondary treatment at similar rates, and had similar mortality. Among patients who did not receive secondary treatment, Black patients had higher hazards of prostate cancer-specific mortality and all-cause mortality. The authors conclude that disparities in mortality outcomes among patients who did not receive secondary treatment for prostate cancer raise concerns about inequities in health care access and quality.