Compared to their non-Hispanic White counterparts, most Hispanic patients with localized prostate cancer are nearly 20% more likely to have aggressive disease, but the risk varies based on their country of origin, researchers reported in study findings published in Prostate Cancer and Prostatic Diseases. Additionally, they found that the population faces disparities in access to care, with only approximately 60% receiving appropriate treatment.
Using data from 895,087 patients in the National Cancer Database who were diagnosed with localized prostate adenocarcinoma from 2004–2017, the researchers analyzed patients by race, ethnicity, and country of origin.
Overall, they found that Hispanic patients had 18% greater odds of having higher-risk localized prostate cancer compared with non-Hispanic White patients but were 62% less likely to receive treatment. However, when the researchers included country of origin among the factors, they found that patients of Mexican descent had the highest risk for aggressive disease whereas patients of Cuban descent had about the same risk as non-Hispanic White patients. Comparatively, Hispanic Black patients were less likely have higher-risk disease than non-Hispanic Black patients but were nearly two times more likely to receive treatment.
The researchers suggested that social determinants of health could explain the wide variations in risk, such as:
- Cultural predisposition to engage in preventive care
- Better overall access to care
- Likelihood to self-advocate or seek second opinions
- Availability of healthcare coverage, healthy diet, safe areas to exercise, access to public parks, and other public health services
- Pollution or other environmental and geographic factors
“This study suggests there are different environmental, societal, and cultural exposures,” the researchers said. They also issued a challenge to their peers to consider studying populations more closely than by today’s broad, socially defined racial and ethnic categories: “It shows the importance of looking at Hispanic patients by desegregated groups, but the same approach could be applied to country of origin for Blacks, Asians, Pacific Islanders, or any heterogeneous group that has been broadly defined.”