Race Related To Prostate Surgery Quality
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Black men needing surgery for advanced prostate cancer seem to have worse outcomes than white men, according to a new study. Based on data collected from hospitals in three states, black men who had their prostates removed were more likely to need blood transfusions, stay in the hospital longer and die while hospitalized compared to white men. They also had lower quality of care, the research suggested. Compared to whites, black men were 27 percent less likely to have their surgery at a hospital that routinely removes prostates and 33 percent less likely to be seen by a surgeon experienced in the procedure, known as radical prostatectomy.
According to the American Cancer Society, over 241,000 men will be diagnosed with prostate cancer in the U.S. in 2012, and over 28,000 will die from it. Black men seem to be disproportionately represented in both of those numbers. They are 59 percent more likely to develop prostate cancer and more than twice as likely to die from it compared to white men, according to earlier research.
“There seems to be some event that happens after diagnosis that leads to worse outcomes,” said Dr. Daniel Barocas, the study’s lead author and an assistant professor of urologic surgery at Vanderbilt University in Nashville, Tennessee. It could be that black men choose different or less aggressive treatments than white men, said Barocas. He and his team decided to look specifically at whether quality of care differs by race.
The researchers consulted information on 105,972 adult men who had their prostates removed because of cancer at hospitals in Florida, Maryland and New York between 1996 and 2007.
Of those, 81,112 patients were white and 14,006 were black. Barocas told Reuters Health that two possible solutions could be to send patients to regional hospitals that then perform a large number of the surgeries, or to send experienced surgeons to community hospitals. But, he noted, black men in the study who went to the high-volume hospitals and surgeons were still at greater risk of complications than white men.
He said there seem to be other differences based on race, such as how men’s cancers progress and economic factors. “I have a suspicion what we’re detecting is an access issue and an economic issue,” said Barocas. “Those problems probably need to be addressed at a level beyond the healthcare system in terms of a policy point of view.”