Quantifying the Cumulative Impact of Differences in Care on Prostate Cancer Outcomes

摘要

The purpose of this training award is to undertake research focused on evaluating whether racial differences in access to and intensity of medical care for prostate cancer are a fundamental cause of the disparity in prostate cancer outcomes. This work involves first developing a computer model that determines whether population trends in obesity affect race-based disparities in prostate cancer incidence and mortality. We used NHANES data on the rising prevalence of obesity from 1980-2002 together with SEER data on prostate cancer incidence to estimate the effect of obesity on prostate cancer incidence and mortality. Our key finding is that high-grade prostate cancer incidence in 2002 was 13% higher, and high-grade prostate cancer mortality was 6% higher than would have been expected had the prevalence of obesity remained unchanged from 1980-2002. The second phase of this project involves examining how care patterns are correlated throughout all phases of cancer care, and whether race- based differences in patterns of care contribute to observed disparities in prostate cancer incidence and mortality. Exploratory analyses have revealed that obesity and smoking are both associated with prostate cancer screening. Work to be performed in Year 3 will examine race-based differences in screening behavior.