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Eradicating Health Care Disparities in the Surgical Management of Prostate Cancer

Arthur L. Burnett

Racial disparities in the arena of prostate cancer epidemiology and survival outcomes are conjectured to extend to the surgical management of this disease, particularly to the extent that African-American men encounter less favorable curative opportunities and disease control impact among racial groups in this regard. A literature review was performed to examine the utilization trends and therapeutic efficacy aspects of radical prostatectomy for clinically localized prostate cancer in African-American men. African-American men carry an adverse prostate cancer risk profile, with distinctive tumor biologic implications, although multiple risk factors across disease, patient, and provider domains are contributory. Delayed screening for this disease in African-American men, relative to Caucasian-American men, coupled with racial variations in patterns and quality of care, are highly relevant variables accounting for decreased radical prostatectomy utilization. Reports exist both in support of and in opposition to therapeutic efficacy equivalence among racial groups after radical prostatectomy. The racial variation in surgical care for prostate cancer can be addressed by applying both pattern and quality of care improvements in the delivery of surgical treatment. Future research advances will also be beneficial for advising optimal treatment based on targeted risk profiles.