CNP for Older Underserved African American Adults

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DESCRIPTION (provided by applicant): Prostate cancer deaths for that of Metropolitan Detroit have consistently exceeded that of the State of Michigan and the most of the United States. Black men are twice as likely to die from prostate cancer as are White men. Thus, it has been suggested that Detroit's racial makeup, with 80% of the males being Black, is the reason why the Detroit Metropolitan Area has one of the highest prostate cancer mortality rates in the country. Prior research has shown that, nationally, the racial/ethnic disparity in prostate cancer mortality is greatly affected by racial disparities in the use of definitive therapy for clinically localized prostate cancer. Within Metropolitan Detroit the impact of the racial disparity in prostate cancer treatment on the reported racial prostate cancer disparity in mortality is unknown. We will conduct a cross sectional study utilizing Metropolitan Detroit Surveillance Epidemiology End Result (SEER) tumor registry-Medicare Database to determine if racial/ethnic differences exist in the use of definitive treatment (radical prostatectomy and radiation therapy) for localized prostate cancer. If such differences are found, we will attempt to identify their causes. We hypothesize that within Metropolitan Detroit there is significant racial/ethnic disparity in the use of definitive therapy for clinically localized prostate cancer. Furthermore, this racial/ethnic disparity in the use of definitive therapy is tumor grade dependent resulting in a wider treatment disparity among men with higher-grade tumors. We will use the Surveillance Epidemiology End Result (SEER) Tumor Registry- Medicare Database to address the following specific aims: I) Determine the racial patterns in the use of definitive therapy (radical prostatectomy and radiation therapy) among men in metropolitan Detroit who where 65 years of age and older diagnosed with clinically localized prostate cancer between 1992 thru 2002. II) Determine the influence of patient's comorbid disease status, socioeconomic status and cancer severity measures on the reported racial/ethnic disparity in use of definitive therapy in men in metropolitan Detroit who where 65 years of age and older diagnosed with clinically localized prostate cancer between 1992 thru 2002.