Researchers at Fox Chase Cancer Center found that the odds of a patient undergoing prostate cancer surgery were lower among Black patients compared with white patients during the initial wave of the COVID-19 pandemic.
The results were published in JAMA Oncology.
“If you look at the prostate cancer literature there is an unfortunate signal that Black patients do worse than white patients when it comes to prostate cancer outcomes,” Andres F. Correa, author on the study and assistant professor for the Department of Surgical Oncology at Fox Chase, said in a statement.
“Historically there has been interest in exploring possible genetic links that may explain the difference in outcomes between Black and white patients. Recent reports, however, have demonstrated that when you provide equal care, those differences go away,” he said.
The study was prompted by early reports showing that minority populations were disproportionately adversely affected by the COVID-19 pandemic. Correa said they sought to assess how a significant stressor, such as the lockdown, affected the delivery of routine cancer care within a certain region.
The study compared prostatectomy rates between Black and white patients with untreated, non-metastatic prostate cancer during the COVID-19 pandemic and was based on numbers from the Pennsylvania Urologic Regional Collaborative database.
“Prior to the pandemic, there was no difference in the rate of surgery for Black and white patients diagnosed with prostate cancer,” said Adrien Bernstein, lead author on the study and second year urologic oncology fellow at Fox Chase. “During the pandemic, however, Black men were 97% less likely than white men to undergo a prostatectomy.”
The study further demonstrated that these changes in care were not secondary to difference in prostate cancer severity or the risk of severe COVID-19 infections. Rather, the disparity in surgical treatment was driven by clear systemic variations—institutions that cared for a greater proportion of black patients experience a greater decline in operative volume.
The researchers note that this study highlights the potential frailty of the healthcare system and caution that patterns such as those reported in the study are likely unfolding across medicine.
“Healthcare disparities are often multifactorial in origin and represent a key determinant of health. Only by bringing these inequities to light are we able to begin the work to rectify them,” said Bernstein. “Different policies were enacted for different communities. While prostate cancer surgery can be safely delayed up to a year, balanced mitigation strategies are needed as we continue to navigate the COVID-19 pandemic.”
