Stage‐Specific Racial Disparities in Prostate Cancer Survival Outcomes

ABSTRACT Background Racial disparities in prostate cancer (PCa) survival are inconsistently reported. Methods We evaluated long‐term survival in 976 men from the NCI–Maryland PCa case‐control study, stratified by disease stage. Results There were no survival differences observed between African American (AA) and European American (EA) men with Stage 1 or 2 disease. In contrast, AA men with Stage 3 or 4 PCa experienced significantly higher prostate cancer‐specific and all‐cause mortality in equal‐access Veterans Affairs (VA) and non‐VA settings. Adjustment for baseline prostate‐specific antigen (PSA) level, Gleason score, and treatment modalities attenuated but did not eliminate these differences. Conclusions Disparate survival outcomes for AA men with PCa emerge mainly at Stage 3 or 4 diagnosis, emphasizing the importance of early detection for these men. Notably, AA patients with advanced‐stage disease were more likely to receive hormone therapy alone, a treatment pattern that may contribute to racial disparities in PCa survival.