Race May Affect Quality of Prostate Cancer Surgical Care

TUESDAY, Aug. 28 (HealthDay News) -- Black prostate cancer patients may receive lower-quality surgical care than white patients, according to a new study.

Researchers analyzed the medical records of nearly 106,000 prostate cancer patients who underwent radical prostatectomy (removal of the prostate) in Florida, Maryland and New York state between 1996 and 2007.

Previous studies have found that prostate cancer patients who are treated at high-volume hospitals by surgeons who perform many prostatectomies have better outcomes and a lower risk of death.

This study found that black men were 33 percent less likely to have a high-volume surgeon and 27 percent less likely to be treated in a high-volume hospital, compared to white men. Black patients also had a higher rate of blood transfusion, longer hospital stays and were more likely to die in the hospital.

Black patients who used high-volume surgeons in high-volume hospitals had a much lower risk for adverse outcomes, including death, than those who used lower-volume health care providers. However, they still fared worse than white patients, the investigators found.

The study was published in the Aug. 17 issue of the Journal of Urology.

"Our findings of racial variation in the quality of surgical care for prostate cancer adds to previous studies that have shown racial differences in screening behavior, stage at presentation and use of aggressive treatment, and may contribute to our understanding of why black men have much higher prostate cancer mortality than white men," study leader Dr. Daniel Barocas, of the Vanderbilt-Ingram Cancer Center in Nashville, Tenn., said in a Vanderbilt University Medical Center news release.

More than 2 million American men are prostate cancer survivors, according to the American Cancer Society.

The new findings suggest that black prostate cancer patients may have more difficulty gaining access to good care, Barocas said.

"Racial disparities in prostate cancer outcomes may be partially explained by differences in access to high-quality care, which in turn may reflect differences in patient resources," Barocas said. "To close this gap, we may need interventions aimed at improving access to high-quality care for all men, including access to high-volume health care providers."