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Impact of socioeconomic status and race on clinical parameters of patients undergoing radical prostatectomy in an equal access health care system.

Abstract：

OBJECTIVES:To analyze the relationships among socioeconomic status (SES), race, and the clinical parameters of patients undergoing radical prostatectomy (RP) in an equal access health care system. METHODS:The Department of Defense Center for Prostate Disease Research longitudinal prostate cancer database from multiple military institutions was used to analyze the clinical, pathologic, and outcome data of 1058 patients with localized (Stage T2c or lower) prostate cancer and a preoperative prostate-specific antigen (PSA) level of 20 ng/mL or less who underwent RP between January 1987 and December 1997. Military rank (officer versus enlisted) was used as a surrogate measure of SES. RESULTS:The percentage of patients with pathologic Gleason grade 7 or greater prostate cancer was higher in enlisted (45%) than in officer (37%) patients (P = 0. 021). However, no difference was found between these groups with respect to pathologic stage or biochemical recurrence rates. African Americans presented at a younger age (P = 0.003), with a higher pretreatment PSA level (P = 0.001), and demonstrated higher biochemical recurrence rates than other ethnic groups (P = 0.037). The Cox proportional hazards analysis showed that a lower SES (P = 0.010) but not African American race (P = 0.696) was an independent predictor of a higher grade (Gleason grade 7 or higher) cancer. However, biochemical progression was more common in African American men (P = 0.035) and was not related to SES (P = 0.883). CONCLUSIONS:In an equal access health care system, patients of lower SES presented with higher grade prostate cancer at the time of RP. However, only African American race predicted biochemical progression after RP.

journal_name

Urology

journal_title

Urology

authors

Tarman GJ,Kane CJ,Moul JW,Thrasher JB,Foley JP,Wilhite D,Riffenburgh RH,Amling CL

doi

10.1016/s0090-4295(00)00808-6

subject

Has Abstract

pub_date

2000-12-20 00:00:00

pages

1016-20

issue

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(00)00808-6

journal_volume

pub_type

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Impact of socioeconomic status and race on clinical parameters of patients undergoing radical prostatectomy in an equal access health care system.