Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina

Wendy Demark-Wahnefried, Joellen M. Schildkraut, Christophe E. Iselin, Elizabeth Conlisk, Andrew Kavee, Tim E. Aldrich, Eugene Lengerich, Philip J. Walther, David F. Paulson

Research output: Contribution to journalArticle

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Abstract

BACKGROUND. In the U.S., prostate carcinoma mortality is greatest among African Americans. In North Carolina, the state with the fourth largest population of African Americans, the prostate carcinoma mortality rate is 2.5 times greater among African Americans than among whites and is the highest reported rate for any state in the nation. To explore potential reasons for the racial differential in mortality, a study was undertaken to determine whether differences related to treatment existed between African American and white men who were diagnosed with prostate carcinoma during the period 1994- 1995. METHODS. Cases were selected from 16 institutions within a region comprising 63 contiguous counties where the overall population was >20% African American. A stratified design was employed to accrue subjects into groups of even size according to race and disease stage (n = 231). A telephone survey was conducted, which assessed treatment options discussed by patients with their physicians, treatment(s) received, factors influencing treatment, satisfaction with treatments discussed and options given, and sociodemographic information. RESULTS. All measures related to treatment were consistently associated with stage at diagnosis (P < 0.001) rather than other variables measured (i.e., race, age, income, comorbidity, education, and residential status). Furthermore, most subjects reported that their physicians presented several treatment options (65%), that they were satisfied with the options presented (905), and that the physician was the most important factor influencing their treatment decision (57%). CONCLUSIONS. These data suggest that African American and white men in North Carolina receive comparable treatment for prostate carcinoma. Therefore, efforts to reduce the racial disparity in mortality should be directed toward lessening the high incidence of later stage disease at diagnosis and exploring potential biologic differences that may increase the risk of more aggressive disease among African Americans.

Original languageEnglish (US)
Pages (from-to)320-330
Number of pages11
JournalCancer
Volume83
Issue number2
DOIs
StatePublished - Jul 15 1998

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African Americans
Prostate
Carcinoma
Therapeutics
Mortality
Physicians
Telephone
Population
Comorbidity
Education
Incidence

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Demark-Wahnefried, W., Schildkraut, J. M., Iselin, C. E., Conlisk, E., Kavee, A., Aldrich, T. E., ... Paulson, D. F. (1998). Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina. Cancer, 83(2), 320-330. https://doi.org/10.1002/(SICI)1097-0142(19980715)83:2<320::AID-CNCR16>3.0.CO;2-V
Demark-Wahnefried, Wendy ; Schildkraut, Joellen M. ; Iselin, Christophe E. ; Conlisk, Elizabeth ; Kavee, Andrew ; Aldrich, Tim E. ; Lengerich, Eugene ; Walther, Philip J. ; Paulson, David F. / Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina. In: Cancer. 1998 ; Vol. 83, No. 2. pp. 320-330.
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title = "Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina",
abstract = "BACKGROUND. In the U.S., prostate carcinoma mortality is greatest among African Americans. In North Carolina, the state with the fourth largest population of African Americans, the prostate carcinoma mortality rate is 2.5 times greater among African Americans than among whites and is the highest reported rate for any state in the nation. To explore potential reasons for the racial differential in mortality, a study was undertaken to determine whether differences related to treatment existed between African American and white men who were diagnosed with prostate carcinoma during the period 1994- 1995. METHODS. Cases were selected from 16 institutions within a region comprising 63 contiguous counties where the overall population was >20{\%} African American. A stratified design was employed to accrue subjects into groups of even size according to race and disease stage (n = 231). A telephone survey was conducted, which assessed treatment options discussed by patients with their physicians, treatment(s) received, factors influencing treatment, satisfaction with treatments discussed and options given, and sociodemographic information. RESULTS. All measures related to treatment were consistently associated with stage at diagnosis (P < 0.001) rather than other variables measured (i.e., race, age, income, comorbidity, education, and residential status). Furthermore, most subjects reported that their physicians presented several treatment options (65{\%}), that they were satisfied with the options presented (905), and that the physician was the most important factor influencing their treatment decision (57{\%}). CONCLUSIONS. These data suggest that African American and white men in North Carolina receive comparable treatment for prostate carcinoma. Therefore, efforts to reduce the racial disparity in mortality should be directed toward lessening the high incidence of later stage disease at diagnosis and exploring potential biologic differences that may increase the risk of more aggressive disease among African Americans.",
author = "Wendy Demark-Wahnefried and Schildkraut, {Joellen M.} and Iselin, {Christophe E.} and Elizabeth Conlisk and Andrew Kavee and Aldrich, {Tim E.} and Eugene Lengerich and Walther, {Philip J.} and Paulson, {David F.}",
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Demark-Wahnefried, W, Schildkraut, JM, Iselin, CE, Conlisk, E, Kavee, A, Aldrich, TE, Lengerich, E, Walther, PJ & Paulson, DF 1998, 'Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina', Cancer, vol. 83, no. 2, pp. 320-330. https://doi.org/10.1002/(SICI)1097-0142(19980715)83:2<320::AID-CNCR16>3.0.CO;2-V

Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina. / Demark-Wahnefried, Wendy; Schildkraut, Joellen M.; Iselin, Christophe E.; Conlisk, Elizabeth; Kavee, Andrew; Aldrich, Tim E.; Lengerich, Eugene; Walther, Philip J.; Paulson, David F.

In: Cancer, Vol. 83, No. 2, 15.07.1998, p. 320-330.

Research output: Contribution to journalArticle

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T1 - Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina

AU - Demark-Wahnefried, Wendy

AU - Schildkraut, Joellen M.

AU - Iselin, Christophe E.

AU - Conlisk, Elizabeth

AU - Kavee, Andrew

AU - Aldrich, Tim E.

AU - Lengerich, Eugene

AU - Walther, Philip J.

AU - Paulson, David F.

PY - 1998/7/15

Y1 - 1998/7/15

N2 - BACKGROUND. In the U.S., prostate carcinoma mortality is greatest among African Americans. In North Carolina, the state with the fourth largest population of African Americans, the prostate carcinoma mortality rate is 2.5 times greater among African Americans than among whites and is the highest reported rate for any state in the nation. To explore potential reasons for the racial differential in mortality, a study was undertaken to determine whether differences related to treatment existed between African American and white men who were diagnosed with prostate carcinoma during the period 1994- 1995. METHODS. Cases were selected from 16 institutions within a region comprising 63 contiguous counties where the overall population was >20% African American. A stratified design was employed to accrue subjects into groups of even size according to race and disease stage (n = 231). A telephone survey was conducted, which assessed treatment options discussed by patients with their physicians, treatment(s) received, factors influencing treatment, satisfaction with treatments discussed and options given, and sociodemographic information. RESULTS. All measures related to treatment were consistently associated with stage at diagnosis (P < 0.001) rather than other variables measured (i.e., race, age, income, comorbidity, education, and residential status). Furthermore, most subjects reported that their physicians presented several treatment options (65%), that they were satisfied with the options presented (905), and that the physician was the most important factor influencing their treatment decision (57%). CONCLUSIONS. These data suggest that African American and white men in North Carolina receive comparable treatment for prostate carcinoma. Therefore, efforts to reduce the racial disparity in mortality should be directed toward lessening the high incidence of later stage disease at diagnosis and exploring potential biologic differences that may increase the risk of more aggressive disease among African Americans.

AB - BACKGROUND. In the U.S., prostate carcinoma mortality is greatest among African Americans. In North Carolina, the state with the fourth largest population of African Americans, the prostate carcinoma mortality rate is 2.5 times greater among African Americans than among whites and is the highest reported rate for any state in the nation. To explore potential reasons for the racial differential in mortality, a study was undertaken to determine whether differences related to treatment existed between African American and white men who were diagnosed with prostate carcinoma during the period 1994- 1995. METHODS. Cases were selected from 16 institutions within a region comprising 63 contiguous counties where the overall population was >20% African American. A stratified design was employed to accrue subjects into groups of even size according to race and disease stage (n = 231). A telephone survey was conducted, which assessed treatment options discussed by patients with their physicians, treatment(s) received, factors influencing treatment, satisfaction with treatments discussed and options given, and sociodemographic information. RESULTS. All measures related to treatment were consistently associated with stage at diagnosis (P < 0.001) rather than other variables measured (i.e., race, age, income, comorbidity, education, and residential status). Furthermore, most subjects reported that their physicians presented several treatment options (65%), that they were satisfied with the options presented (905), and that the physician was the most important factor influencing their treatment decision (57%). CONCLUSIONS. These data suggest that African American and white men in North Carolina receive comparable treatment for prostate carcinoma. Therefore, efforts to reduce the racial disparity in mortality should be directed toward lessening the high incidence of later stage disease at diagnosis and exploring potential biologic differences that may increase the risk of more aggressive disease among African Americans.

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