Prostate cancer is the second leading cause of cancer-related mortality in men. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of articles published from 1968 to 2007 assessing survival from prostate cancer was conducted. Analysis of unadjusted studies reported that African American men have an increased risk of all-cause mortality (hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.31-1.65, p < .001). However, examination of adjusted studies identified no difference (HR = 1.07, 95% CI = 0.94-1.22, p = .308). No statistically significant difference was observed in prostate cancer—specific survival in both analyses using unadjusted (HR = 1.11, 95% CI = 0.94-1.31, p = .209) and adjusted studies (HR = 1.15, 95% CI = 0.95-1.41, p = .157). This meta-analysis concludes that there are no racial differences in the overall and prostate cancer—specific survival between African American and White men.
Alexander, G.A., & Brawley, O.W. ( 1998). Prostate cancer treatment outcome in blacks and whites: A summary of the literature. Seminars in Urologic Oncology , 16, 232-234.
2.
American Cancer Society. (2007). Cancer facts & figures for African Americans 2007-2008. Atlanta, GA: Author.
3.
American Cancer Society. (2008). Cancer facts & figures 2008. Atlanta, GA: Author.
4.
Aziz, H., Rotman, M., Thelmo, W., Chen, P., Choi, K.N., Khil, S.U., et al. (1988). Radiation-treated carcinoma of prostate: Comparison of survival of black and white patients by Gleason’s grading system. American Journal of Clinical Oncology, 11, 166-171.
5.
Bach, P.B., Schrag, D., Brawley, O.W., Galaznik, A., Yakren, S., & Begg, C.B. ( 2002). Survival of blacks and whites after a cancer diagnosis . Journal of the American Medical Association, 287, 2106-2113.
6.
Berman, N.G., & Parker, R.A. ( 2002). Meta-analysis: Neither quick nor easy. Medical Research Methodology, 2, 10.
7.
Berry, W.R., Laszlo, J., Cox, E., Walker, A., & Paulson, D. ( 1979). Prognostic factors in metastatic and hormonally unresponsive carcinoma of the prostate. Cancer, 44, 763-775.
8.
Bonovas, S., Filioussi, K., & Sitaras, N.M. ( 2006). Paracetamol use and risk of ovarian cancer: A meta-analysis . British Journal of Clinical Pharmacology, 62, 113-121.
9.
Brawn, P.N., Johnson, E.H., Kuhl, D.L., Riggs, M.W., Speights, V.O., Johnson, C.F., III, et al. (1993). Stage at presentation and survival of white and black patients with prostate carcinoma. Cancer, 71, 2569-2573.
10.
Crawford, E.D., Blumenstein, B.A., Goodman, P.J., Davis, M.A., Eisenberger, M.A., McLeod, D.G., et al. (1990). Leuprolide with and without flutamide in advanced prostate cancer. Cancer, 66(Suppl. 5), 1039-1044.
11.
Dayal, H.H., & Chiu, C. ( 1982). Factors associated with racial differences in survival for prostatic carcinoma. Journal of Chronic Diseases, 35, 553-560.
12.
Dayal, H.H., Polissar, L., & Dahlberg, S. ( 1985). Race, socioeconomic status, and other prognostic factors for survival from prostate cancer. Journal of the National Cancer Institute, 74, 1001-1006.
13.
Du, X.L., Fang, S., Coker, A.L., Sanderson, M., Aragaki, C., Cormier, J.N., et al. (2006). Racial disparity and socioeconomic status in association with survival in older men with local/regional stage prostate carcinoma: Findings from a large community-based cohort. Cancer, 106, 1276-1285.
14.
Evans, S., Metcalfe, C., Ibrahim, F., Persad, R., & Ben-Shlomo, Y. (2008). Investigating black-white differences in prostate cancer prognosis: A systematic review and meta-analysis . International Journal of Cancer/Journal International Du Cancer, 123, 430-435.
15.
Fowler, J.E., Jr., Bigler, S.A., Bowman, G., & Kilambi, N.K. ( 2000). Race and cause specific survival with prostate cancer: Influence of clinical stage, Gleason score, age and treatment. Journal of Urology, 163, 137-142.
16.
Freeman, V.L., Durazo-Arvizu, R., Keys, L.C., Johnson, M.P., Schafernak, K., & Patel, V.K. ( 2004). Racial differences in survival among men with prostate cancer and comorbidity at time of diagnosis. American Journal of Public Health, 94, 803-808.
17.
Friedenreich, C.M., Brant, R.F., & Riboli, E. ( 1994). Influence of methodologic factors in a pooled analysis of 13 case-control studies of colorectal cancer and dietary fiber. Epidemiology, 5(1), 66-79.
18.
Gilliland, F.D., Hunt, W.C., & Key, C.R. ( 1996). Ethnic variation in prostate cancer survival in New Mexico . Cancer Epidemiology, Biomarkers & Prevention, 5, 247-251.
19.
Godley, P.A., Schenck, A.P., Amamoo, M.A., Schoenbach, V.J., Peacock, S., Manning, M., et al. (2003). Racial differences in mortality among Medicare recipients after treatment for localized prostate cancer. Journal of the National Cancer Institute, 95, 1702-1710.
20.
Greenland, S. ( 1994). Invited commentary: A critical look at some popular meta-analytic methods. American Journal of Epidemiology, 140, 290-296.
21.
Halabi, S., Vogelzang, N.J., Ou, S.S., Kelly, W.K., & Small, E.J. ( 2006). Clinical outcomes by age in men with hormone refractory prostate cancer: A pooled analysis of 8 Cancer and Leukemia Group B (CALGB) studies. Journal of Urology, 176(1), 81-86.
22.
Harris, R., & Lohr, K.N. ( 2002). Screening for prostate cancer: An update of the evidence for the U.S. preventive services task force. Annals of Internal Medicine, 137, 917-929.
23.
Hart, K.B., Porter, A.T., Shamsa, F., Chuba, P.J., Pontes, J.E., & Forman, J.D. ( 1998). The influence of race on the efficacy of curative radiation therapy for carcinoma of the prostate. Seminars in Urologic Oncology, 16, 227-231.
24.
Hussain, F., Aziz, H., Macchia, R., Avitable, M., & Rotman, M. ( 1992). High grade adenocarcinoma of prostate in smokers of ethnic minority groups and Caribbean island immigrants. International Journal of Radiation Oncology, Biology, Physics, 24, 451-461.
25.
Iselin, C.E., Box, J.W., Vollmer, R.T., Layfield, L.J., Robertson, J.E., & Paulson, D.F. ( 1998). Surgical control of clinically localized prostate carcinoma is equivalent in African-American and white males. Cancer , 83, 2353-2360.
26.
Johnstone, P.A., Kane, C.J., Sun, L., Wu, H., Moul, J.W., McLeod, D.G., et al. (2002). Effect of race on biochemical disease-free outcome in patients with prostate cancer treated with definitive radiation therapy in an equal-access health care system: Radiation oncology report of the department of defense center for prostate disease research. Radiology, 225, 420-426.
27.
Jones, G.W., Mettlin, C., Murphy, G.P., Guinan, P., Herr, H.W., Hussey, D.H., et al. (1995). Patterns of care for carcinoma of the prostate gland: Results of a national survey of 1984 and 1990. Journal of the American College of Surgeons, 180, 545-554.
28.
Juni, P., Witschi, A., Bloch, R., & Egger, M. ( 1999). The hazards of scoring the quality of clinical trials for meta-analysis. Journal of the American Medical Association , 282, 1054-1060.
29.
Khuntia, D., Reddy, C.A., Mahadevan, A., Klein, E.A., & Kupelian, P.A. (2004). Recurrence-free survival rates after external-beam radiotherapy for patients with clinical T1-T3 prostate carcinoma in the prostate-specific antigen era: What should we expect? Cancer, 100, 1283-1292.
30.
Kim, J.A., Kuban, D.A., el-Mahdi, A.M., & Schellhammer, P.F. (1995). Carcinoma of the prostate: Race as a prognostic indicator in definitive radiation therapy. Radiology, 194, 545-549.
31.
McLeod, D.G., Schellhammer, P.F., Vogelzang, N.J., Soloway, M.S., Sharifi, R., Block, N.L., et al. (1999). Exploratory analysis on the effect of race on clinical outcome in patients with advanced prostate cancer receiving bicalutamide or flutamide, each in combination with LHRH analogues: The Casodex combination study group. The Prostate, 40, 218-224.
32.
Oakley-Girvan, I., Kolonel, L.N., Gallagher, R.P., Wu, A.H., Felberg, A., & Whittemore, A.S. (2003). Stage at diagnosis and survival in a multiethnic cohort of prostate cancer patients. American Journal of Public Health, 93, 1753-1759.
33.
Optenberg, S.A., Thompson, I.M., Friedrichs, P., Wojcik, B., Stein, C.R., & Kramer, B. ( 1995). Race, treatment, and long-term survival from prostate cancer in an equal-access medical care delivery system. Journal of the American Medical Association, 274, 1599-1605.
34.
Parmar, M.K., Torri, V., & Stewart, L. ( 1998). Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Statistics in Medicine, 17, 2815-2834.
35.
Peters, N., & Armstrong, K. ( 2005). Racial differences in prostate cancer treatment outcomes: A systematic review. Cancer Nursing, 28, 108-118.
36.
Pienta, K.J., Demers, R., Hoff, M., Kau, T.Y., Montie, J.E., & Severson, R.K. (1995). Effect of age and race on the survival of men with prostate cancer in the metropolitan Detroit tri-county area, 1973 to 1987. Urology, 45, 93-102.
37.
Polednak, A.P. ( 2003). Black-white differences in survival from late-stage prostate cancer. Ethnicity & Disease, 13, 220-225.
38.
Powell, I.J., Schwartz, K., & Hussain, M. ( 1995). Removal of the financial barrier to health care: Does it impact on prostate cancer at presentation and survival? A comparative study between black and white men in a Veterans’ Affairs system. Urology, 46, 825-830.
39.
Powell, I.J., Banerjee, M., Bianco, F.J., Wood, D.P., Jr., Dey, J., Lai, Z., et al. (2004). The effect of race/ethnicity on prostate cancer treatment outcome is conditional: A review of Wayne state university data. Journal of Urology, 171, 1508-1512.
40.
Roach, M., III. ( 1998). Is race an independent prognostic factor for survival from prostate cancer?Journal of the National Medical Association , 90(Suppl. 11), S713-S719.
41.
Roach, M., III, Lu, J., Pilepich, M.V., Asbell, S.O., Mohiuddin, M., & Grignon, D. ( 2003). Race and survival of men treated for prostate cancer on radiation therapy oncology group phase III randomized trials. Journal of Urology, 169, 245-250.
42.
Robbins, A.S., Whittemore, A.S., & Van Den Eeden, S.K. (1998). Race, prostate cancer survival, and membership in a large health maintenance organization. Journal of the National Cancer Institute, 90, 986-990.
43.
Robbins, A.S., Whittemore, A.S., & Thom, D.H. ( 2000). Differences in socioeconomic status and survival among white and black men with prostate cancer. American Journal of Epidemiology, 151, 409-416.
44.
Stroup, D.F., Berlin, J.A., Morton, S.C., Olkin, I., Williamson, G.D., Rennie, D., et al. (2000). Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. Journal of the American Medical Association, 283, 2008-2012.
45.
Tewari, A., Horninger, W., Pelzer, A.E., Demers, R., Crawford, E.D., Gamito, E.J., et al. (2005). Factors contributing to the racial differences in prostate cancer mortality. BJU International, 96, 1247-1252.
46.
Tewari, A., Raman, J.D., Chang, P., Rao, S., Divine, G., & Menon, M. ( 2006). Long-term survival probability in men with clinically localized prostate cancer treated either conservatively or with definitive treatment (radiotherapy or radical prostatectomy). Urology , 68, 1268-1274.
47.
Thompson, I., Tangen, C., Tolcher, A., Crawford, E., Eisenberger, M., & Moinpour, C. ( 2001). Association of African-American ethnic background with survival in men with metastatic prostate cancer. Journal of the National Cancer Institute, 93, 219-225.
48.
Tierney, J.F., Stewart, L.A., Ghersi, D., Burdett, S., & Sydes, M.R. ( 2007). Practical methods for incorporating summary time-to-event data into meta-analysis. Trials, 8, 16.
49.
Wyatt, R.B., Sanchez-Ortiz, R.F., Wood, C.G., Ramirez, E., Logothetis, C., & Pettaway, C.A. (2004). Prognostic factors for survival among Caucasian, African-American and Hispanic men with androgen-independent prostate cancer. Journal of the National Medical Association , 96, 1587-1593.
50.
Zagars, G.K., Pollack, A., & Pettaway, C.A. (1998). Prostate cancer in African-American men: Outcome following radiation therapy with or without adjuvant androgen ablation. International Journal of Radiation Oncology, Biology, Physics, 42, 517-523.
