Racial/ethnic disparities in prostate cancer stage of diagnosis in Florida

Background: Few studies have examined racial/ethnic differences in prostate cancer (PC) stage of diagnosis controlling for sociodemographic variables. The objective of this study was to determine if an association exists between race/ethnicity and PC stage of diagnosis after adjusting for age, education level, marital, smoking and insurance status, SES and urban/rural residence. Methods: The Florida Cancer Data System was used to obtain data from men (n=99,912) diagnosed with PC between the years 2001 and 2009 of which 74% were non-Hispanic White (White), 13% non-Hispanic Black (Black), 12% Hispanic and 1% non-Hispanic Other (Other). Most men had localized (90%) PC at diagnosis compared to those with advanced (regional/distant) stage (10%). Univariate and multivariate logistic regression models were fitted to stage of PC presentation (localized vs. advanced) with race/ethnicity as the main predictor but further adjusted for sociodemographic factors. Results: Black men were more likely to present with advanced disease than White men (OR 1.38; 95% CI 1.36 – 1.46). After adjusting for sociodemographic factors, this association remained (OR 1.16; 95% CI 1.09 – 1.23). Hispanics and men of Other race/ethnicity showed no statistically significant difference in PC stage presentation compared to Whites. Conclusions: Disparities in PC stage of diagnosis exist in a racial/ethnically diverse state like Florida; Black men were 38% more likely than White men to present with advanced PC disease. This likelihood was reduced by 16% after adjusting for sociodemographic factors. These results confirm the need for additional research to elucidate the causes for PC disparities among Black men.