Ethnic heterogeneity and prostate cancer mortality in Hispanic/Latino men: a population-based study

Chinea, Felix M.; Patel, Vivek N.; Kwon, Deukwoo; Lamichhane, Narottam; Lopez, Christopher; Punnen, Sanoj; Kobetz, Erin; Abramowitz, Matthew C.; Pollack, Alan

doi:10.18632/oncotarget.19068

Cited by 38 publications

(46 citation statements)

References 37 publications

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“…Although disparities in outcomes among black men with advanced prostate cancer are well established, to the best of our knowledge less is known regarding Hispanic men with this lethal disease. Chinea et al examined a large cohort of men with prostate cancer and observed that, even among Hispanic men, substantial ethnic heterogeneity exists and may influence prostate cancer–specific mortality . Unfortunately, in cancer registry data, >40% of Hispanic/Latino patients have unspecified Hispanic origin.…”

Section: Discussionmentioning

confidence: 99%

“…Chinea et al examined a large cohort of men with prostate cancer and observed that, even among Hispanic men, substantial ethnic heterogeneity exists and may influence prostate cancer-specific mortality. 30 Unfortunately, in cancer registry data, >40% of Hispanic/Latino patients have unspecified Hispanic origin. Therefore, future research will need to examine disaggregated race/ethnicity data to determine whether differences in ADT strategy exist among different subgroups (eg, Mexican American, Puerto Rican) and whether cultural factors contribute to observed disparities.…”

Section: Discussionmentioning

confidence: 99%

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Differential use of medical versus surgical androgen deprivation therapy for patients with metastatic prostate cancer

Borno

Lichtensztajn

Gomez

et al. 2018

Cancer

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Background Surgical and medical androgen deprivation therapy (ADT) strategies are comparable in their ability to suppress serum testosterone levels as treatment in patients with metastatic prostate cancer but differ with regard to cost and impact on quality of life. Medical ADT is associated with better long‐term quality of life due to the flexibility of possible therapy interruption but comes with a higher cumulative cost. In the current study, the authors examined whether surgical ADT (ie, bilateral orchiectomy) was used differentially by race/ethnicity and other social factors. Methods The authors identified patients with metastatic disease at the time of diagnosis through the California Cancer Registry. The association between race/ethnicity and receipt of surgical ADT was modeled using multivariable Firth logistic regression adjusting for age, Gleason score, prostate‐specific antigen level, clinical tumor and lymph node classification, neighborhood socioeconomic status (SES), insurance, marital status, comorbidities, initial treatment (radiotherapy, chemotherapy), location of care, rural/urban area of residence, and year of diagnosis. Results The authors examined a total of 10,675 patients with metastatic prostate cancer, 11.4% of whom were non‐Hispanic black, 8.4% of whom were Asian/Pacific Islander, 18.5% of whom were Hispanic/Latino, and 60.5% of whom were non‐Hispanic white. In the multivariable model, patients found to be more likely to receive surgical ADT were Hispanic/Latino (odds ratio [OR], 1.32; 95% confidence interval [95% CI], 1.01‐1.72), were from a low neighborhood SES (OR, 1.96; 95% CI, 1.34‐2.89) or rural area (OR, 1.49; 95% CI, 1.15‐1.92), and had Medicaid/public insurance (OR, 2.21; 95% CI, 1.58‐3.10). Patients with military/Veterans Affairs insurance were significantly less likely to receive surgical ADT compared with patients with private insurance (OR, 0.34; 95% CI, 0.13‐0.88). Conclusions Race/ethnicity, neighborhood SES, and insurance status appear to be significantly associated with receipt of surgical ADT. Future research will need to characterize other differences in initial treatments among men with advanced prostate cancer based on race/ethnicity and aim to better understand what factors drive the association between surgical ADT among men of Hispanic origin or those from areas with low neighborhood SES.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Differential use of medical versus surgical androgen deprivation therapy for patients with metastatic prostate cancer

Borno

Lichtensztajn

Gomez

et al. 2018

Cancer

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“…We selected model parameters that were broadly based on known or putative prostate cancer risk factors as well as the following clinical and demographic information in the data set: age, 7 body mass index (BMI), 8 diabetes status, 9 smoking status, 10 emphysema, asthma, race 11 (white, black, Native American, Asian, or multiracial), ethnicity 12 (Hispanic or other), hypertension, 13 heart disease, 14 vigorous exercise habits, 15 and history of stroke. 16 We included these parameters in the ANN for two main reasons: For the purposes of potential future clinical integration, these parameters are routinely captured in the EMR, and in contrast to traditional statistical models, ANNs can do a better job at deciphering nonlinear relationships and making strong inferences with interdependent variables.…”

Section: Data Sets and Parameter Selectionmentioning

confidence: 99%

Development and Validation of a Multiparameterized Artificial Neural Network for Prostate Cancer Risk Prediction and Stratification

Roffman

Hart

Leapman

et al. 2018

JCO Clinical Cancer Informatics

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Purpose To develop and validate a multiparameterized artificial neural network (ANN) on the basis of personal health information for prostate cancer risk prediction and stratification. Methods The 1997 to 2015 National Health Interview Survey adult survey data were used to train and validate a multiparameterized ANN, with parameters including age, body mass index, diabetes status, smoking status, emphysema, asthma, race, ethnicity, hypertension, heart disease, exercise habits, and history of stroke. We developed a training set of patients ≥ 45 years of age with a first primary prostate cancer diagnosed within 4 years of the survey. After training, the sensitivity and specificity were obtained as functions of the cutoff values of the continuous output of the ANN. We also evaluated the ANN with the 2016 data set for cancer risk stratification. Results We identified 1,672 patients with prostate cancer and 100,033 respondents without cancer in the 1997 to 2015 data sets. The training set had a sensitivity of 21.5% (95% CI, 19.2% to 23.9%), specificity of 91% (95% CI, 90.8% to 91.2%), area under the curve of 0.73 (95% CI, 0.71 to 0.75), and positive predictive value of 28.5% (95% CI, 25.5% to 31.5%). The validation set had a sensitivity of 23.2% (95% CI, 19.5% to 26.9%), specificity of 89.4% (95% CI, 89% to 89.7%), area under the curve of 0.72 (95% CI, 0.70 to 0.75), and positive predictive value of 26.5% (95% CI, 22.4% to 30.6%). For the 2016 data set, the ANN classified all 13,031 patients into low-, medium-, and high-risk subgroups and identified 5% of the cancer population as high risk. Conclusion A multiparameterized ANN that is based on personal health information could be used for prostate cancer risk prediction with high specificity and low sensitivity. The ANN can further stratify the population into three subgroups that may be helpful in refining prescreening estimates of cancer risk.

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“…The available national data on the epidemiology of cancer among diverse racial/ethnic groups are commonly reported by broad racial/ethnic categories such as “Hispanic.” Few studies have investigated differences by Hispanic subgroup ( 16 , 30 ). Existing studies have considered rates in specific states such as Florida ( 16 , 31 ), but do not include all Hispanic subgroups ( 29 , 32 ), or focus on only one specific cancer type ( 33 ).…”

Section: Introductionmentioning

confidence: 99%

Unpacking Hispanic Ethnicity—Cancer Mortality Differentials Among Hispanic Subgroups in the United States, 2004–2014

Tyson

Medina-Ramírez

Flores

et al. 2018

Front. Public Health

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Introduction: National data on the epidemiology of cancer are commonly reported by broad racial/ethnic categories, such as “Hispanic.” However, few studies have disaggregated Hispanic groups and explored mortality differentials in this heterogeneous population. This paper aims to further examine cancer mortality differentials among Hispanic subgroups in the U.S.Materials and Methods: The study examined cancer deaths in the United States from 2004 to 2014 among decedents classified as Mexican, Puerto Rican, Cuban, Dominican, Central/South American and non-Hispanic white on the death certificate among those who were 20 years or older at the time of death. Data were obtained from the National Vital Statistics System. Sex-specific age-adjusted mortality rates were computed for a 10-year period and each individual year, for all cancers combined. Differences by age group, cancer sites, and age distribution were also assessed.Results: A total of 296,486 Hispanic cancer deaths were identified. Mortality rates of the Hispanic subgroups compare favorably with those of non-Hispanic whites. The mortality rates for Mexicans are very similar to those of all Hispanics combined, whereas the rates for Cuban and Puerto Ricans are higher. Dominicans and Central/South Americans had the overall lowest mortality rates. Statistically significant decreases in cancer mortality rates were noted in some sub-groups, but rates increased among Dominican women. Age-adjusted mortality rates by cancer site varied among Hispanics subgroups and gender. Among Cubans, only 5% of cancer deaths occurred before the age of 50 compared to 16% of cancer deaths among Central/South American.Conclusion: While it is common to present data on the burden of cancer among Hispanics as an aggregate group, this study illustrates that the burden of cancer varies by Hispanic subgroups. The disaggregation of Hispanics by ancestry/country of origin allows for a clearer understanding of the health status of this growing population and is needed if health disparities are to be adequately identified, understood and addressed.

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Ethnic heterogeneity and prostate cancer mortality in Hispanic/Latino men: a population-based study

Cited by 38 publications

References 37 publications

Differential use of medical versus surgical androgen deprivation therapy for patients with metastatic prostate cancer

Differential use of medical versus surgical androgen deprivation therapy for patients with metastatic prostate cancer

Development and Validation of a Multiparameterized Artificial Neural Network for Prostate Cancer Risk Prediction and Stratification

Unpacking Hispanic Ethnicity—Cancer Mortality Differentials Among Hispanic Subgroups in the United States, 2004–2014

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