Health Disparities in Prostate Cancer and Approaches to Advance Equitable Care

Abstract

The American Cancer Society estimates approximately 268,490 new cases of prostate cancer and approximately 34,500 deaths caused by prostate cancer in the United States for 2022. Globally, a total of 1,414,259 new cases of prostate cancer and 375,304 related deaths were reported in 2020. Well-documented health disparities and inequities exist along the continuum of care for prostate cancer management—from screening to diagnostic and staging work-up, surveillance, and treatment—ultimately impacting clinical outcomes. This session-based article discusses innovative patient-centered approaches to advance equitable prostate cancer care. It begins with a review of domestic health disparities in diagnostic imaging and radiotherapy for prostate cancer, and it summarizes barriers and solutions to achieving health equity, such as equity metrics and practice quality improvement projects. Next, a global perspective is provided that describes approaches to address financial and geographic barriers to prostate cancer care, including specific examples of strategies that emphasize the use of the cheapest method of care delivery while maintaining outcomes for drug delivery and radiotherapy.

Declining Representation and Reporting of Racial and Ethnic Minority Patients in Prostate Cancer Clinical Trials Despite Persistent Health Disparities—Where Progress Confronts Limitations

“…Similarly, a growing body of evidence advises that omnipresent disparities in prostate cancer outcomes are reduced or eliminated in the context of clinical trials which provide both equal and equitable care. 7 A multiple-cohort study of more than 300 000 patients with prostate cancer found that Black race was not associated with inferior prostate cancerspecific mortality in cohorts from NCI-sponsored randomized clinical trials and the Veterans Affairs health system, while it was associated with increased prostate cancer-specific mortality within the SEER registry, suggesting that with similar access to care and standardized treatment, Black men with nonmetastatic prostate cancer appeared to have comparable stage-forstage prostate cancer-specific mortality to White men. 8 Much literature has been devoted to the challenges of enrollments and inclusion of racial and ethnic minority groups and mar-ginalized demographic groups in the US and corresponding strategies to reduce them.…”

The Path Forward Toward Health Equity in Radiation Oncology in a Post-2020 Era

“… 19 Implementing such educational efforts and quality equity metrics into clinical practice and quality improvement projects (eg, monitoring time to treatment and technology utilization across sociodemographic groups) will provide an initial path to mitigate disparities and achieve health equity in radiation oncology. 20 …”

Statistical Data (1978-2020) on Prostate Cancer in the Southern Population of Mexico

“…Source: GLOBOCAN 2020. [11] Regarding North America and specifically the United States, [12] some reports show an incidence of new cases of prostate cancer (268,490) and 12.84% of deaths (34,500) in the year 2022. In addition, recently a study displayed that there was an increase in the incidence and mortality of prostate cancer in Canada during 1992-2010.…”