190878 Racial disparities in Prostate cancer survival: A Meta-analysis

Sunday, October 26, 2008

Gayathri Sridhar, MBBS, MPH, (PhD) , Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Tilahun Adera, MPH, PhD , Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Ramesh Ramakrishnan, PhD , Department of Biostatistics, Virginia Commonwealth University, Richmond, VA
John D. Roberts, MD , Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
C.M. Kinloch Nelson, MD , Virginia Urology, Richmond, VA
Saba Masho, MD, MPH, DrPH , Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Introduction: Prostate cancer is the second leading cause of cancer related mortality in men. Previous studies have drawn inconsistent conclusions on racial differences in prostate cancer survival. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer.

Methods: A Medline/PubMed search of all published articles from 1968 to 2007 assessing the survival from prostate cancer among African American and White men was conducted. The search yielded 20 eligible published manuscripts. Meta-analysis was done to examine racial differences in the overall and prostate cancer-specific survival. Summary hazard ratios and 95% confidence intervals were derived using fixed and random effects models. Tests of heterogeneity were used to select the appropriate model. Sensitivity analysis and publication bias were assessed. Further subgroup and meta-regression analysis were performed. Results: Analysis of unadjusted studies showed that the overall survival for African American men with prostate cancer was significantly lower than White men (HR 1.470, 95% CI 1.310, 1.650, p<0.0001). However, examination of studies that adjusted for pertinent covariates showed no statistically significant difference (HR 1.069, 95% CI 0.935, 1.222, p=0.326). Additionally, no statistically significant difference was observed in prostate cancer-specific survival between African American and White men in both analysis using unadjusted (HR 1.108, 95% CI 0.930, 1.321, p=0.251) and adjusted studies (HR 1.153, 95% CI 0.946, 1.405, p=0.159).

Conclusion: This meta-analysis concludes that there are no racial differences in the overall and prostate cancer-specific survival between African American and White men.

Learning Objectives:
Assess if there are racial differences in survival from prostate cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PhD Candidate in Epidemiology
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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