Poverty, Not Race, Lowers Prostate Cancer Survival

NEW YORK MAR 01, 2006 (Reuters Health) - The racial gap seen in the outcome of prostate cancer among older men is primarily due to differences in socioeconomic status, according to the results of a large community-based study. 

The exception is Hispanic men, who have the highest rates of survival, but a socioeconomic status on par with African American men.

"Lower socioeconomic status appeared to be one of the major barriers to achieving comparable outcomes for men with prostate carcinoma," Dr. Xianglin L. Du, from the University of Texas School of Public Health in Houston, and colleagues report in the medical journal Cancer.

The findings are based on analysis of data from 61,228 men, 65 years of age or older, who were diagnosed with prostate cancer between 1992 and 1999.  The subjects were from 11 US geographic areas and were followed for up to 11 years.

After factoring in age, other illnesses, tumor grade, and treatment, men in with the lowest socioeconomic status were 31 percent more likely to die than those at the highest socioeconomic level, the report indicates.

The "marginally significant" survival advantage for white men compared with African American men disappeared after adjusting for socioeconomic factors, the researchers note.  By contrast, Hispanic men continued to have a lower risk of death than the other groups after adjusting for these factors.

The exact reason for this "Hispanic Paradox", as it has come to be called, is unclear, Du"s team notes.  It could be related to the "healthy immigrant theory" and may reflect strong social support.  Still, the number of Hispanics in the study was relatively small, which may have led to "unstable results," they point out. 

"These findings have important public health implications if we are to achieve the goals of Healthy People 2010, one of which is to eliminate health disparities among different segments of the population," the researchers conclude.

SOURCE:

• Cancer, March 15, 2006.