Dr. Bin Huang joined colleagues from the Centers for Disease Control and Prevention to publish “Prostate cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study.” The article appears in the December 5, 2017, issue of the journal Cancer.
The 5-year relative survival for prostate cancers diagnosed between 1990 and 1994 in the United States was very high at 92 percent; however, survival in black males was 7 percent lower compared with white males. The authors updated these findings and examined survival by stage and race.
The investigators used data from the CONCORD-2 study for males (ages 15-99 years) who were diagnosed with prostate cancer in 37 states, covering 80% of the US population. Survival was adjusted for background mortality (net survival) using state-specific and race-specific life tables and was age-standardized. Data were presented for 2001 through 2003 and 2004 through 2009 to account for changes in collecting SEER Summary Stage 2000.
Among the 1,527,602 prostate cancers diagnosed between 2001 and 2009, the proportion of localized cases increased from 73 percent to 77 percent in black males and from 77 percent to 79 percent in white males. Although the proportion of distant-stage cases was higher among black males than among white males, they represented less than 6% of cases in both groups between 2004 and 2009. Net survival exceeded 99 percent for localized stage between 2004 and 2009 in both racial groups. Overall, and in most states, 5-year net survival exceeded 95 percent.
In conclusion, the authors note that prostate cancer survival has increased since the first CONCORD study, and the racial gap has narrowed. Earlier detection of localized cancers likely contributed to this finding. However, racial disparities also were observed in overall survival. To help understand which factors might contribute to the persistence of this disparity, states could use local data to explore sociodemographic characteristics, such as survivors' health insurance status, health literacy, treatment decision-making processes, and treatment preferences.
Dr. Bin Huang is an Associate Professor in the Division of Cancer Biostatistics in the University of Kentucky College of Public Health Department of Biostatistics and the Biostatistics Shared Resource Facility at the Markey Cancer Center, and Director of Population-Based Cancer Research at the Kentucky Cancer Registry.