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Prostate cancer characteristics and cancer-specific mortality of Native American patients

Prostate Cancer and Prostatic Diseases volume 23, pages 277–285 (2020)Cite this article

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Abstract

Background

Historical epidemiological data indicate that Native American patients may have worse prostate cancer (PCa) characteristics than Caucasian patients (CAP). To test for cancer-specific mortality (CSM) differences among Native American vs. CAP, the most contemporary version of the SEER database (Surveillance, Epidemiology, and End Results database [2004−2016]) was used.

Methods

Descriptives and time trend analyses focused on a combined cohort of 357,289 Caucasian and Native American PCa patients of all stages. After 1:4 propensity-score (PS) matching for stage, grade, and other patient characteristics, cumulative incidence plots, and competing-risks-regression-models (CRR) were used, with further stratification according to non-metastatic (TanyN0M0) vs. metastatic (TanyN1 and/or M1) stages.

Results

Native American patients accounted for 1804 (0.5%) of the study cohort. Native American patients had higher PSA (8 ng/ml vs. 6.3 ng/ml), higher rate of D’Amico high-risk PCa (30.8 vs. 24.8%), higher rate of T3/T4-PCa (5.5 vs. 3.7%), higher rate of N1 stage (4.5 vs. 2.8%), and higher rate of M1 stage (7.5 vs. 3.9%, all p < 0.001) than CAP. In TanyN0M0 patients after PS-matching, 10-year CSM was 5.7 vs. 6.2% in Native American vs. CAP. In TanyN1 and/or M1 patients, 10-year CSM was 64.3 vs. 63.3% in Native American vs. CAP, (both p = 0.8). In CRR, Native American race did not represent an independent predictor of CSM.

Conclusions

Native American patients have more unfavorable stage and grade at presentation. However, after adjustment for these characteristics, CSM in Native American patients is not higher than in CAP. In consequence, PCa prognosis does not differ between Native American and Caucasian race. Therefore, efforts should be made to diagnose PCa in Native Americans at an earlier and more favorable stage like in CAP.

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Authors and Affiliations

  1. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany

    Marina Deuker & Felix Chun

  2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada

    Marina Deuker, Sophie Knipper, Angela Pecoraro, Carlotta Palumbo, Giuseppe Rosiello, Stefano Luzzago, Zhe Tian, Fred Saad & Pierre I. Karakiewicz

  3. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Sophie Knipper

  4. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy

    Angela Pecoraro

  5. Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy

    Carlotta Palumbo

  6. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Giuseppe Rosiello

  7. European Institute of Oncology, Milan, Italy

    Stefano Luzzago

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  1. Marina Deuker
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Correspondence to Marina Deuker.

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Deuker, M., Knipper, S., Pecoraro, A. et al. Prostate cancer characteristics and cancer-specific mortality of Native American patients. Prostate Cancer Prostatic Dis 23, 277–285 (2020). https://doi.org/10.1038/s41391-019-0184-8

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