Patient Race and Outcome Preferences as Predictors of Urologists' Treatment Recommendations and Referral Patterns in Early-Stage Prostate Cancer; Final rept. 31 Oct 2004-30 Oct 2007

摘要

African American men with localized prostate cancer are about 25% to 30% less likely than non-Hispanic white men to be treated with radical prostatectomy (RP), even when adjustments are made for age, tumor characteristics, sociodemographic characteristics, and comorbid conditions 1- 11. Lower rates of prostatectomy among African Americans are intriguing because virtually all patients see urologists for confirmatory biopsies and for initial discussions about treatment, and because most urologists view prostatectomy as the best option for cure 12. Although African Americans are more likely to fear surgery and distrust physicians than members of other racial/ethnic groups 13,18 - and may therefore refuse prostatectomy when offered - it is important to ascertain whether treatment disparities also emerge from systematic differences in clinician recommendations or, possibly, impaired opportunities for African American men to participate in therapeutic decision-making.