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Racial Disparities in the Quality of Prostate Cancer Care

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Technical Report,01 Sep 2011,31 Aug 2015

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Mount Sinai School of Medicine New York United States

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For younger men 65 years of age with high risk locally advanced stage 2C, active treatment with surgery or radiotherapy appears to improve disease-free and overall survival as compared to active surveillance no active treatment. Minority men are less likely to receive active treatment but the reasons for this havent been evaluated in younger men. Since black men with prostate cancer are younger at diagnosis, more likely to have poorly differentiated tumors, less likely to receive active treatment and more likely than white men to die of prostate cancer, it is possible that the quality of prostate cancer care delivered may be contributing to the racial disparity in mortality. While it is clear that physician recommendation and physician specialty affects the type of prostate cancer treatment recommended and ultimately received, little is known about racial differences in which treatments are offered to minority vs nonminority men and why. Nor are there data explaining younger minority mens lower rates of active treatment in circumstances when active surveillance does not achieve the same benefits of active treatment. This proposal seeks to determine whether the quality of care received by minority men with locally advanced prostate cancer differs from the care received by white men controlling for comorbidity, age and insurance. We are looking at reasons for the treatment choices minority men make including their experiences, their physicians recommendations, beliefs about the prostate cancer, its treatment and consequences and assess racial differences in beliefs and potential causes of poorer quality care and, are exploring urologists, radiation oncologists and medical oncologists perceptions of their decision-making and referrals among men with locally advanced prostate cancer.

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