Genetic Testing in the Safety Net: Improving Equity in Prostate Cancer Treatment
[Technical Report, Annual Report]
BOSTON MEDICAL CENTER CORP MA
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Prostate cancer treatment advances and associated mortality benefits have left behind substantial segments of the US population. African American men have a higher incidence of prostate cancer 203.5 vs. 121.9 per 100,000 and are 2-3 times more likely to die of prostate cancer relative to white men.1-3 These disparities are due in large part to the receipt of less effective treatment. Socioeconomic status is a major independent contributor to survival ten years post-diagnosis, those in the highest socioeconomic strata have a 15 higher survival rate compared to those in the lowest strata.4 Genetic testing to guide treatment decision making is now recommended for certain prostate cancer patients following diagnosis of localized disease and all patients with metastatic disease. Treatment-based disparity gaps may continue to be exacerbated by the underutilization of genetic testing in racialethnic minorities and those with low socioeconomic status. The complex underlying reasons for alack of uptake of genetic testing in vulnerable patient populations remain largely unexplored. Thus, there is a critical need to elucidate the multidimensional reasons for disparities in treatment utilization for minority and low-income men with prostate cancer that reside at the system, provider, and patient levels.
- Medicine and Medical Research