Prostate cancer disparities in Hispanics by country of origin: a nationwide population-based analysis

BACKGROUND: We sought to evaluate prostate cancer (PCa) characteristics and outcomes of Hispanics living in the United States by country of origin in the Surveillance, Epidemiology and End Results (SEER) program. METHODS: Retrospective analysis of 72,134 adult Hispanics with PCa between 1995-2014. Origin was Mexican (N=16,995; 24%), South/Central American (N=6,949; 10%), Puerto Rican (N=3,582; 5%), Cuban (N=2,587; 4%), Dominican (N=725; 1%), Hispanic not specified (NOS, N=41,296; 57%), as coded by SEER. Patient and PCa characteristics were analyzed with chi-square and Kruskal-Wallis tests. Overall and PCa survival were analyzed with Kaplan-Meier and Cox models adjusting for baseline variables. RESULTS: At diagnosis, Mexicans had more advanced stage, higher prostate-specific antigen and higher Gleason score while Cubans and Dominicans had more favorable PCa at diagnosis (all P<0.05). After a median follow up of 69 months, 20,317 men died, including 6,223 PCa deaths. Compared to Mexicans, Cubans (HR=1.22, 95%CI=[1.14-1.30]) and Puerto Ricans (HR=1.15 [1.08-1.22]) had worse overall survival while Dominicans (HR=0.76 [0.64-0.91]), South/Central Americans (HR=0.68, [0.65-0.72]) and NOS (HR=0.81 [0.78-0.84]) had better overall survival. Compared to Mexicans, Cubans (HR=1.08, [0.96-1.22]) and Puerto Ricans (HR=1.03, [0.92-1.15]) had similar PCa survival while Dominicans (HR=0.72, [0.53-0.98]), South/Central Americans (HR=0.67 [0.60-0.74]) and NOS (HR=0.68 [0.64-0.73]) had significantly better PCa survival. CONCLUSIONS: Among Hispanics in the United States, disparities in PCa characteristics and survival by country of origin exist, with Dominicans, South/Central Americans and Hispanic NOS having better PCa survival compared to Mexicans, Cubans and Puerto Ricans.