ArticleJournal of racial and ethnic health disparities2026
Active Surveillance for Prostate Cancer in "Real-World" Setting: Exploring Racial Disparities.
Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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Who cites it
1 citing paper in PubMed.
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Authors and funding
18 authors.
Funding
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Abstract
INTRODUCTION AND
objectivesActive surveillance (AS) is a safe management strategy for low-risk prostate cancer (PCa), but limited "real-world" data exist outside trial cohorts. This study investigates racial disparities in progression to treatment, upgrading, and prostate cancer-specific mortality (PCSM) in a real-world AS population, aiming to improve healthcare quality.
methodsWe retrospectively analyzed data from the Henry Ford Health System (1995-2023) for men diagnosed with PCa (Gleason Grade ≤ 2, ≤ cT2c, N0-M0, PSA ≤ 20 ng/ml, age < 76 years) and enrolled in AS with ≥ 1 post-diagnosis PSA or biopsy and ≥ 1 year follow-up. Non-Hispanic Blacks (NHBs) and Non-Hispanic Whites (NHWs) were included. Surveillance adequacy was defined as ≥ 1 PSA/year and ≥ 1 biopsy every 4 years. Competing-risk cumulative incidence and regression assessed disparities in progression to treatment, upgrading, and PCSM.
resultsAmong 864 patients (38% NHBs, 62% NHWs), NHBs presented with more advanced disease, including higher rates of GG2 (29% vs. 18%, p < 0.001) and intermediate-risk PCa (39% vs. 32%, p = 0.04). Surveillance adequacy was lower in NHBs (38% vs. 50%, p < 0.001). NHBs progressed to treatment more frequently (45% vs. 36%, p < 0.001), with a 1.46-fold higher risk (95% CI: 1.14-1.87, p = 0.003). NHBs had no higher odds of upgrading but showed higher 10-year PCSM (5.6% vs. 1.4%) and 5.9-fold higher odds of PCSM (95% CI: 1.38-25.37, p = 0.01).
conclusionsNHBs under AS face more advanced disease, lower follow-up adequacy, higher progression to treatment, and elevated PCSM odds. Targeted strategies are needed to address these disparities and improve equitable PCa care.
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