Evidence map›Paper›PMID 38565911›Full record

ArticleProstate cancer and prostatic diseases2024

Emerging racial disparities among Medicare beneficiaries and Veterans with metastatic castration-sensitive prostate cancer.

Daniel J George, Neeraj Agarwal, Krishnan Ramaswamy, Zachary Klaassen, Rhonda L Bitting, David Russell, Rickard Sandin, Birol Emir, Hongbo Yang, Wei Song and 4 more

Open access · hybridAbstract read
In one paragraph

Article in Prostate cancer and prostatic diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
3.4field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Cancer treatment and survivorship statistics, 2025.CA: a cancer journal for clinicians
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 2 countries.

Daniel J GeorgeDepartment of Medicine, Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA. Daniel.George@duke.edu.ORCID 0000-0002-0836-8542
Neeraj AgarwalDepartment of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.ORCID 0000-0003-1076-0428
Krishnan RamaswamyPfizer Inc., New York, NY, USA.ORCID 0000-0003-0890-0268
Zachary KlaassenDepartment of Surgery, Medical College of Georgia at Augusta University, Georgia Cancer Center, Augusta, GA, USA.ORCID 0000-0001-7392-8916
Rhonda L BittingDepartment of Medicine, Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0002-5253-0551
David RussellPfizer Inc., New York, NY, USA.
Rickard SandinPfizer AB, Sollentuna, Sweden.
Birol EmirPfizer Inc., New York, NY, USA.
Hongbo YangAnalysis Group, Inc., Boston, MA, USA.
Wei SongAnalysis Group, Inc., Boston, MA, USA.
Yilu LinDepartment of Health Policy and Management, Tulane University, New Orleans, LA, USA.
Agnes HongPfizer Inc., New York, NY, USA.
Wei GaoAnalysis Group, Inc., Boston, MA, USA.
Stephen J FreedlandSection of Urology, Durham VA Medical Center, Durham, NC, USA.ORCID 0000-0002-8104-6419
Pfizer (United States) · USAnalysis Group (United States) · USDuke University · USAugusta University · USCedars-Sinai Medical Center · USPfizer (Sweden) · SETulane University · USUniversity of Utah · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious studies have shown that Black men receive worse prostate cancer care than White men. This has not been explored in metastatic castration-sensitive prostate cancer (mCSPC) in the current treatment era.

methodsWe evaluated treatment intensification (TI) and overall survival (OS) in Medicare (2015-2018) and Veterans Health Administration (VHA; 2015-2019) patients with mCSPC, classifying first-line mCSPC treatment as androgen deprivation therapy (ADT) + novel hormonal therapy; ADT + docetaxel; ADT + first-generation nonsteroidal antiandrogen; or ADT alone.

resultsWe analyzed 2226 Black and 16,071 White Medicare, and 1020 Black and 2364 White VHA patients. TI was significantly lower for Black vs White Medicare patients overall (adjusted odds ratio [OR] 0.68; 95% confidence interval [CI] 0.58-0.81) and without Medicaid (adjusted OR 0.70; 95% CI 0.57-0.87). Medicaid patients had less TI irrespective of race. OS was worse for Black vs White Medicare patients overall (adjusted hazard ratio [HR] 1.20; 95% CI 1.09-1.31) and without Medicaid (adjusted HR 1.13; 95% CI 1.01-1.27). OS was worse in Medicaid vs without Medicaid, with no significant OS difference between races. TI was significantly lower for Black vs White VHA patients (adjusted OR 0.75; 95% CI 0.61-0.92), with no significant OS difference between races.

conclusionsGuideline-recommended TI was low for all patients with mCSPC, with less TI in Black patients in both Medicare and the VHA. Black race was associated with worse OS in Medicare but not the VHA. Medicaid patients had less TI and worse OS than those without Medicaid, suggesting poverty and race are associated with care and outcomes.

Indexed as

Healthcare DisparitiesMedicareVeteransAgedAged, 80 and overAndrogen AntagonistsBlack or African AmericanFollow-Up StudiesHumansMaleProstatic Neoplasms, Castration-ResistantSurvival RateUnited StatesWhiteAndrogen Antagonists

Identifiers

PMID38565911
PMCPMC11543599
OpenAlexW4393397959

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.