Clinical Profile, Quality of Care, and Recurrence in Arab-American and Caucasians Prostate Cancer Patients in Michigan

Prostate cancer is the most common cancer among men in the United States with striking differences in incidence and mortality
among ethnic groups. Michigan has one of the largest concentrations of Arab Americans (AAs) in the U.S. and little is known
about this ethnic minority with respect to prostate cancer. This study investigated differences in clinical profile, quality
of care, and recurrence among prostate cancer survivors comparing AAs and Caucasian Americans (CAs). Participants in this
study included 2499 prostate cancer survivors from the Michigan Cancer Registry from 1985 to 2004. Participants completed
surveys regarding health-seeking behavior, post-treatment symptoms, quality of care and recurrence. Ethnicity was self-reported
and AAs and CAs were compared with respect to clinical profile, quality of care, and recurrence. There were 52 AAs and 1886
CAs patients with AAs being younger (

– x

age 68.3 ± SD 21.4 years,

– x

age 72.3 ± SD 14.1 years, for AAs and CAs, respectively) (P = 0.05). AAs had lower socioeconomic standard than CAs (34 vs. 10.6 %, <$20,000 yearly income/year; for AAs vs. CAs, respectively)
(P < 0.0001). AAs reported poorer health than AAs (7.7 vs. 3.0 % for AAs vs. CAs, respectively) (P < 0.0001). AAs were more likely to visit specialists for prostate follow-up (44.5 vs. 19.7 % visited a specialist, for AAs
vs. CAs respectively) (P < 0.0001) and received supplementary healthcare workers (13 % of AAs vs. 3.1 % CAs) (P = 0.032). In addition, AAs reported higher occurrence of urinary incontinence compared to CAs (67.4 vs. 60.4 %, for AAs vs.
CAs, respectively) (P = 0.001). Ethnic background was not a predictor of recurrence [(Odds ratio (OR) = 1.1 (95 % confidence intervals CI = 0.40,
2.9)] (P = 0.873) even after adjusting for age, PSA levels within the last 2 years, metastasis and hormonal therapy. While AAs prostate
cancer patients were different from CAs in age, income, seeking medical care, and health reporting, ethnic background was
not a predictor of recurrence. Future studies of the impact of socioeconomic, demographic and cultural factors, and health
care seeking behavior on long-term survival of prostate cancer in AAs and other ethnic minorities are warranted.