March 1, 2006

Poverty, not race, lowers prostate cancer survival

NEW YORK (Reuters Health) - The racial gap seen in the
outcome of prostate cancer among older men is primarily due to
differences in socioeconomic status, according to the results
of a large community-based study.

The exception is Hispanic men, who have the highest rates
of survival, but a socioeconomic status on par with African
American men.

"Lower socioeconomic status appeared to be one of the major
barriers to achieving comparable outcomes for men with prostate
carcinoma," Dr. Xianglin L. Du, from the University of Texas
School of Public Health in Houston, and colleagues report in
the medical journal Cancer.

The findings are based on analysis of data from 61,228 men,
65 years of age or older, who were diagnosed with prostate
cancer between 1992 and 1999. The subjects were from 11 US
geographic areas and were followed for up to 11 years.

After factoring in age, other illnesses, tumor grade, and
treatment, men in with the lowest socioeconomic status were 31
percent more likely to die than those at the highest
socioeconomic level, the report indicates.

The "marginally significant" survival advantage for white
men compared with African American men disappeared after
adjusting for socioeconomic factors, the researchers note. By
contrast, Hispanic men continued to have a lower risk of death
than the other groups after adjusting for these factors.

The exact reason for this "Hispanic Paradox," as it has
come to be called, is unclear, Du's team notes. It could be
related to the "healthy immigrant theory" and may reflect
strong social support. Still, the number of Hispanics in the
study was relatively small, which may have led to "unstable
results," they point out.

"These findings have important public health implications
if we are to achieve the goals of Healthy People 2010, one of
which is to eliminate health disparities among different
segments of the population," the researchers conclude.

SOURCE: Cancer, March 15, 2006.