Clinical Profile, Quality of Care, and Recurrence in Arab-American and Caucasians Prostate Cancer Patients in Michigan

Abstract

Prostate cancer is the most common cancer among men in the United States with striking differences in incidence and mortality among ethnic groups. Michigan has one of the largest concentrations of Arab Americans (AAs) in the U.S. and little is known about this ethnic minority with respect to prostate cancer. This study investigated differences in clinical profile, quality of care, and recurrence among prostate cancer survivors comparing AAs and Caucasian Americans (CAs). Participants in this study included 2499 prostate cancer survivors from the Michigan Cancer Registry from 1985 to 2004. Participants completed surveys regarding health-seeking behavior, post-treatment symptoms, quality of care and recurrence. Ethnicity was self-reported and AAs and CAs were compared with respect to clinical profile, quality of care, and recurrence. There were 52 AAs and 1886 CAs patients with AAs being younger (x̄ age 68.3 ± SD 21.4 years, x̄ age 72.3 ± SD 14.1 years, for AAs and CAs, respectively) (P = 0.05). AAs had lower socioeconomic standard than CAs (34 vs. 10.6 %, <$20,000 yearly income/year; for AAs vs. CAs, respectively) (P < 0.0001). AAs reported poorer health than AAs (7.7 vs. 3.0 % for AAs vs. CAs, respectively) (P < 0.0001). AAs were more likely to visit specialists for prostate follow-up (44.5 vs. 19.7 % visited a specialist, for AAs vs. CAs respectively) (P < 0.0001) and received supplementary healthcare workers (13 % of AAs vs. 3.1 % CAs) (P = 0.032). In addition, AAs reported higher occurrence of urinary incontinence compared to CAs (67.4 vs. 60.4 %, for AAs vs. CAs, respectively) (P = 0.001). Ethnic background was not a predictor of recurrence [(Odds ratio (OR) = 1.1 (95 % confidence intervals CI = 0.40, 2.9)] (P = 0.873) even after adjusting for age, PSA levels within the last 2 years, metastasis and hormonal therapy. While AAs prostate cancer patients were different from CAs in age, income, seeking medical care, and health reporting, ethnic background was not a predictor of recurrence. Future studies of the impact of socioeconomic, demographic and cultural factors, and health care seeking behavior on long-term survival of prostate cancer in AAs and other ethnic minorities are warranted.

Clinicopathological features, treatment and outcome of Omani patients with localised prostate cancer

“…Our present results are consistent with reports from Korea, China and Saudi Arabia, showing more men to have high-risk disease compared to patients with PCa in Western countries [5,11,13]. Ethnic variations in clinical stage at presentation in patients with PCa are well reported [13][14][15]. For example, minority populations in the USA present with more advanced symptoms and clinical stage of disease compared to the White Caucasian population [13][14][15].…”

“…Ethnic variations in clinical stage at presentation in patients with PCa are well reported [13][14][15]. For example, minority populations in the USA present with more advanced symptoms and clinical stage of disease compared to the White Caucasian population [13][14][15]. These differences may be attributed to socioeconomic differences and access to healthcare rather than ethnic variation, as after corrections for all other factors, only socioeconomic status significantly affected the outcome of Black Americans compared to the White population [13][14][15].…”

“…For example, minority populations in the USA present with more advanced symptoms and clinical stage of disease compared to the White Caucasian population [13][14][15]. These differences may be attributed to socioeconomic differences and access to healthcare rather than ethnic variation, as after corrections for all other factors, only socioeconomic status significantly affected the outcome of Black Americans compared to the White population [13][14][15]. Gleason score was found to be high in the minority ethnicities in the USA and was associated with higher mortality rates.…”

The Health of Arab Americans in the United States: An Updated Comprehensive Literature Review

“…Arab American men were found to be at increased risk of lung and prostate cancer when compared to Hispanic men, but had lower rates when compared to Black men ( 110 ). Manifestations of cancer also differed with Arab American men suffering from higher urinary incontinence associated with prostate cancer than White men ( 111 ). Arab American men had higher rates of bladder cancer than both Hispanic and black men ( 110 ).…”