Does race, income predict prostate cancer outcome?

CHICAGO – A patient's socioeconomic status (income, martial status and race) has absolutely no impact on his outcome following curative radiation therapy for the treatment of prostate cancer, according to a new study from Henry Ford Hospital in Detroit.

"This study offers an extremely important message for all patients with prostate cancer who receive radiation therapy," says Benjamin Movsas, M.D., senior study author and chair of the Department of Radiation Oncology at Henry Ford Hospital in Detroit. "Despite the fact that there was a large difference in income based on race, none of the socioeconomic status factors predicted for outcome. All patients did equally well, based on the known prognostic factors."

The study is being presented Nov. 4 at the 51st Annual American Society for Radiation Oncology (ASTRO) meeting in Chicago. It is unique in that nearly 50 percent of patients in the analysis are African American.

Previous studies on socioeconomic status and cancer outcomes done by other groups have had conflicting results, according to study lead author Farzan Siddiqui, M.D., Ph.D., with the Department of Radiation Oncology at Henry Ford Hospital.

One study, for example, suggested that African Americans with breast or colon cancer do much worse than white patients because they receive care at hospitals with less expertise. Another showed that men with prostate cancer who are married have better outcomes than those who are unmarried or without a partner. And yet other studies suggested that hospitals with large minority patient populations have higher mortality for cancer.

"Henry Ford Hospital treats a large number of African American patients and has excellent cancer outcomes, so we really began to question results from many of these prior studies," says Dr. Siddiqui. "One of the issues is that many of these studies include a relatively small percentage of African American patients. In comparison, almost half of our study group was African American, which allowed us to do a more accurate assessment of how socioeconomic status affects prostate cancer outcomes."

The study included 788 Henry Ford Hospital patients with localized prostate cancer who were treated with external beam radiation therapy. Among those in the study, 48.5 percent were African American with a median household income $36,917, and 46 percent were white with a median household income of $60,190. The patients' ages ranged from 44 to 90.

While there was a large difference in median household income among African Americans and whites, none of the socioeconomic factors examined predicted for patient outcome. Only known disease risk factors determined overall survival or biochemical (PSA) control rates.

"Our results suggest if patients are properly cared for and managed that their race, income and marital status should not affect their outcome," says Dr. Siddiqui.