Racial Disparities Differ for African Americans and Hispanics in the Diagnosis and Treatment of Penile Cancer. Journal Article

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Authors: Slopnick, EA; Kim, SP; Kiechle, JE; Gonzalez, CM; Zhu, H; Abouassaly, R
Article Title: Racial Disparities Differ for African Americans and Hispanics in the Diagnosis and Treatment of Penile Cancer.
Abstract: OBJECTIVE: To evaluate racial disparities in the diagnosis and treatment of penile cancer among a contemporary series of men from a large diverse national data base. MATERIALS AND METHODS: Using the 1998-2012 National Cancer Data Base, all men with squamous cell carcinoma (SCC) were stratified by race and ethnicity. Demographic and disease characteristics were compared between groups. Likelihood of undergoing surgery and type of surgery were compared among patients with nonmetastatic disease. Factors influencing disease stage and treatment type were analyzed with univariate and multivariable logistic regressions. Overall survival was examined with Kaplan-Meier and adjusted Cox proportional hazard models. RESULTS: We identified 12,090 men with penile SCC with median age 66 years (range 18-90). Distribution of patients is as follows: 76.8% Caucasian, 10.2% African American (AA), 8.7% Hispanic. On multivariable analysis, Hispanic men are more likely to present with high-risk (=T1G3) penile SCC (odds ratio [OR] 1.6; confidence interval [CI] 1.20-2.00; P?=?.001) and tend to undergo penectomy rather than penile-sparing surgery (OR 1.46; CI 1.15-1.85; P?=?.002) for equal stage SCC compared to Caucasian patients. Whereas AA men are less likely to undergo surgery of any type (OR 0.67; CI 0.51-0.87; P?=?.003) and have higher mortality rates than Caucasian patients (hazard ratio 1.25; CI 1.10-1.42; P?.001). CONCLUSION: Hispanic men with penile SCC are more likely to present with high-risk disease and undergo more aggressive treatment than Caucasian patients but have comparable survival. AA men are less likely to undergo surgical management of their disease and have higher mortality rates.
Journal Title: Urology
ISSN: 1527-9995; 0090-4295
Publisher: Elsevier Inc  
Date Published: 2016