Under the Right Conditions, Researchers Don’t Find Prostate Cancer Racial Disparities

Black men respond as well as white men to systemic therapies for advanced prostate cancer when access to quality healthcare is equal, regardless of socioeconomic status, according to a new study by Cedars-Sinai Cancer investigators. Published in the Journal of Clinical Oncology, the study counters previous research suggesting that Black men receiving these therapies—which include hormone therapy, chemotherapy and immunotherapy—fare worse than white men do.

“We believe this is the most comprehensive look at this issue to date, and our findings suggest that, under the right conditions, Black men with metastatic prostate cancer can have outcomes equivalent to those of white men,” said Jun Gong, MD, medical director of Colorectal Cancer Medicine at Cedars-Sinai Cancer and first author of the study. “We want all men with advanced prostate cancer to know that, in the right environment, their outcomes can be promising.”

Prostate cancer, which affects the small gland that helps make semen, is the No. 1 cancer diagnosis and second-leading cause of cancer death in Black men. Black men are twice as likely as white men to die of prostate cancer, a fact that has been at least partially attributed to systemic barriers to healthcare for Black men.

Investigators in this study contrasted data from a large database of cancer registries reporting outcomes in all types of healthcare settings with two other types of data. One set of data was collected in healthcare settings including the Department of Veteran’s Affairs, where access to care for Black patients and white is more equal. Another set of data was from randomized clinical trials where all prostate cancer patients received the same treatment, and outcomes for Black versus white patients were compared.

“It was interesting to find that when Black and white men were provided equal access to the same therapies, given at the same dosage and monitored in the same setting, disparities in outcomes were eliminated,” Gong said.

Gong said that the team’s findings point to the need for continued active recruitment of Black men and other minority groups into prostate cancer clinical trials. Community outreach and education are also needed, along with other efforts to provide more equal-access settings for prostate cancer patients.

“Addressing disparities affecting the health of the diverse populations we serve is a priority throughout our institution,” said  Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE ONE Foundation Distinguished Chair. “Through our Community Outreach and Engagement efforts and our ongoing research, we are working to better understand the factors contributing to these disparities, including socioeconomic factors and biological drivers that can be addressed through continued advances in precision medicine.”