Posted on January 8, 2020

Racial/Ethnicity Differences in Endorsing Influential Factors for Prostate Cancer Treatment Choice

Trinh QD, et al., NCBI, December 26, 2019


Rates and choice of treatment for localized prostate cancer vary according to race/ethnicity in American men. We hypothesized that there were group differences in influential values and preferences related to treatment decisions.

We analyzed samples from 2 multicenter, randomized trials of the Patient Profile-Prostate (P3P) I and II decision aid, first comparing the groups on other demographic and decisional variables using Chi-square tests. Stratified (P3P I vs. II) logistic regression was then used to assess the univariate association between race/ethnicity and endorsement of moderate-or-strong influence of 14 lifestyle factors, current or future symptoms, or important others on the decision. A multivariable stratified logistic regression with backward variable selection was used to further estimate the association between influential factors and race/ethnicity.

There were 494 and 392 participants in P3P I and P3P II, respectively, with 40 Hispanic, 168 non-Hispanic black, 637 non-Hispanic white, 19 others and 6 missing. Age (P = 0.0001), education (P < 0.0001), marital status (P < 0.0001), income (P < 0.0001), Internet use for information (P < 0.0001) and decisional control preference were significantly different across racial/ethnic groups. In adjusted analyses, we saw racial/ethnic differences in the decisional influence of age (Non-Hispanic Black (NHB) vs. Non-Hispanic White (NHW) OR: 0.56 95%CI 0.38-0.85 P = 0.002), religion/spirituality (NHB vs. NHW OR: 3.2095%CI1.95-5.26, P < 0.0001), future bladder function (NHB vs. NHW OR: 0.5795%CI 0.35-0.90, P = 0.04), future ability to engage in recreation (NHB vs. NHW OR: 0.5495%CI 0.34-0.86, P = 0.02), and a story of a famous person with prostate cancer (NHB vs. NHW OR: 2,11 95%CI 1.30-3.43, P = 0.007). No interactions were found.

Our results suggest racial/ethnic differences for influences underlying treatment choice. Better understanding these influences may help us present salient information about treatment options to patients and address disparities.