P R O S T A T E C A N C E R R E S E A R C H
Racial and Ethnic Disparities in Prostate Cancer Prognosis with a Focus on Hispanic/Latinos
Medical Student Researcher, Supervised by Dr. Madhur Garg - Department of Radiation Oncology at Montefiore, May 2013 - Present
Used data mining techniques to investigate "Racial and Ethnic Disparities in Prostate Cancer Prognosis with a Focus on Hispanic/Latinos" through Clinical Looking Glass, a software tool for healthcare data at Montefiore Medical Center.
Medical Student Researcher, Supervised by Dr. Madhur Garg - Department of Radiation Oncology at Montefiore, May 2013 - Present
Used data mining techniques to investigate "Racial and Ethnic Disparities in Prostate Cancer Prognosis with a Focus on Hispanic/Latinos" through Clinical Looking Glass, a software tool for healthcare data at Montefiore Medical Center.
- 2015 Albert Einstein College of Medicine - Medical Student Research Poster Exhibit (March 2015, Bronx, NY)
- 2014 American Medical Association Interim Meeting - Poster Presentation (November 2014, Dallas, TX)
A B S T R A C T
PURPOSE: Hispanic/Latinos make up the largest minority group in the United States, constituting 17% of the nation’s total population, and are significantly affected by cancer. Approximately 50% of Hispanic/Latino men are diagnosed with cancer in their lifetime and 20% of Hispanic/Latino men die of cancer. 53,600 new cancer cases are diagnosed among Hispanic/Latino men each year, with prostate cancer the most commonly diagnosed. Motivated by recent prostate cancer literature suggesting that Hispanic/Latino patients have similar outcomes as non-Hispanic/Latino White patients, this study focuses on disparities in prostate cancer prognosis of Hispanic/Latino patients in the Bronx.
METHODS: Prostate cancer data in the last ten years (01/01/2003 – 12/31/2012) were gathered from the Cancer Registry in Clinical Looking Glass, a software tool for healthcare data at Montefiore Medical Center. Montefiore Medical Center is located in the Bronx, which has a mixed patient population with a large proportion of Hispanic/Latino residents. Prognostic factors explored include American Joint Committee on Cancer TNM Classification of Malignant Tumors staging at diagnosis (n=3463) and prostate specific antigen (PSA) levels before (n=4349) and after (n=5848) diagnosis. Prevalence ratios were calculated based on TNM stage of patients at diagnosis. PSA level was adjusted for time length differences in measurement, after which Analysis of Variance (ANOVA) and the Tukey Honest Significant Difference post-hoc test were conducted.
RESULTS: Calculated prevalence ratios showed that Hispanic/Latino patients were 1.45 times as likely to have Stage III prostate cancer when compared to White patients, and 1.37 times as likely to have Stage III prostate cancer when compared to Black/African American patients. Overall, Hispanic/Latino patients were disproportionately diagnosed with Stage III prostate cancer when compared to White and Black/African American patients. There was no difference in prevalence ratio of Stage II and Stage IV prostate cancer diagnosis between Hispanic/Latino versus White or Black/African American patients. For adjusted PSA level before and after diagnosis, there was no significant difference between Hispanic/Latino, Black/African American, and White patients. However, the difference between adjusted PSA levels of Hispanic/Latino and White patients before diagnosis approached significance (p=0.08), with Hispanic patients having higher adjusted PSA levels than White patients before diagnosis.
CONCLUSIONS: The high prevalence ratio of Stage III diagnoses in Hispanic/Latino patients versus White and Black/African American patients suggests that Hispanic/Latino patients have worse prostate cancer prognostic factors at diagnosis. The underlying causes of these disparities are worth investigating as there may be insufficient prostate cancer outreach in Hispanic/Latino communities.
PURPOSE: Hispanic/Latinos make up the largest minority group in the United States, constituting 17% of the nation’s total population, and are significantly affected by cancer. Approximately 50% of Hispanic/Latino men are diagnosed with cancer in their lifetime and 20% of Hispanic/Latino men die of cancer. 53,600 new cancer cases are diagnosed among Hispanic/Latino men each year, with prostate cancer the most commonly diagnosed. Motivated by recent prostate cancer literature suggesting that Hispanic/Latino patients have similar outcomes as non-Hispanic/Latino White patients, this study focuses on disparities in prostate cancer prognosis of Hispanic/Latino patients in the Bronx.
METHODS: Prostate cancer data in the last ten years (01/01/2003 – 12/31/2012) were gathered from the Cancer Registry in Clinical Looking Glass, a software tool for healthcare data at Montefiore Medical Center. Montefiore Medical Center is located in the Bronx, which has a mixed patient population with a large proportion of Hispanic/Latino residents. Prognostic factors explored include American Joint Committee on Cancer TNM Classification of Malignant Tumors staging at diagnosis (n=3463) and prostate specific antigen (PSA) levels before (n=4349) and after (n=5848) diagnosis. Prevalence ratios were calculated based on TNM stage of patients at diagnosis. PSA level was adjusted for time length differences in measurement, after which Analysis of Variance (ANOVA) and the Tukey Honest Significant Difference post-hoc test were conducted.
RESULTS: Calculated prevalence ratios showed that Hispanic/Latino patients were 1.45 times as likely to have Stage III prostate cancer when compared to White patients, and 1.37 times as likely to have Stage III prostate cancer when compared to Black/African American patients. Overall, Hispanic/Latino patients were disproportionately diagnosed with Stage III prostate cancer when compared to White and Black/African American patients. There was no difference in prevalence ratio of Stage II and Stage IV prostate cancer diagnosis between Hispanic/Latino versus White or Black/African American patients. For adjusted PSA level before and after diagnosis, there was no significant difference between Hispanic/Latino, Black/African American, and White patients. However, the difference between adjusted PSA levels of Hispanic/Latino and White patients before diagnosis approached significance (p=0.08), with Hispanic patients having higher adjusted PSA levels than White patients before diagnosis.
CONCLUSIONS: The high prevalence ratio of Stage III diagnoses in Hispanic/Latino patients versus White and Black/African American patients suggests that Hispanic/Latino patients have worse prostate cancer prognostic factors at diagnosis. The underlying causes of these disparities are worth investigating as there may be insufficient prostate cancer outreach in Hispanic/Latino communities.
