CNP for Older Underserved African American Adults

描述(申请人提供)：底特律大都会的前列腺癌死亡人数一直超过密歇根州和美国大部分地区。黑人男性死于前列腺癌的可能性是白人男性的两倍。因此，有人认为底特律的种族构成，其中80%的男性是黑人，是底特律大都市区前列腺癌死亡率在全国最高的原因之一。先前的研究表明，在全国范围内，前列腺癌死亡率的种族/民族差异在很大程度上受到临床局限性前列腺癌最终治疗方法使用的种族差异的影响。在大都会底特律，前列腺癌治疗中的种族差异对报告的前列腺癌死亡率种族差异的影响尚不清楚。我们将利用大都会底特律监测流行病学最终结果(SEER)肿瘤登记-联邦医疗保险数据库进行一项横断面研究，以确定在使用明确治疗(根治性前列腺切除术和放射治疗)治疗局限性前列腺癌方面是否存在种族/民族差异。如果发现这些差异，我们将尝试确定其原因。我们假设，在底特律大都会地区，在临床局限性前列腺癌的最终治疗方法的使用上，存在着显著的种族/民族差异。此外，在使用明确治疗方面的种族/民族差异取决于肿瘤级别，导致较高级别肿瘤患者的治疗差异更大。我们将使用监测流行病学最终结果(SEER)肿瘤登记-医疗保险数据库来解决以下具体目标：i)确定在1992年至2002年期间被诊断为临床局限性前列腺癌的底特律大都市65岁及以上男性中使用确定治疗(根治性前列腺切除术和放射治疗)的种族模式。Ii)确定患者的共病状况、社会经济状况和癌症严重程度对报告的种族/民族差异的影响。在1992年至2002年期间，65岁及以上的底特律大都市男性被诊断为临床局限性前列腺癌。

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.