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Ingrid Oakley-Girvan, PhD, Laurence N. Kolonel, MD, PhD, Richard P. Gallagher, MA, Anna H. Wu, PhD, Anna Felberg, MS and Alice S. Whittemore, PhD

Ingrid Oakley-Girvan, PhD, Anna Felberg, MS, and Alice S. Whittemore, PhD, are with the Stanford University School of Medicine, Stanford, Calif. Laurence N. Kolonel, MD, PhD, is with the Cancer Center of Hawaii, University of Hawaii at Manoa, Honolulu. Richard P. Gallagher, MA, is with the British Columbia Cancer Agency, Vancouver. Anna H. Wu, PhD, is with the University of Southern California, Los Angeles.

Correspondence: Requests for reprints should be sent to Alice S. Whittemore, PhD, Stanford University School of Medicine, Department of Health Research and Policy, Redwood Building, Room T204, Stanford, CA 94305-5405 (e-mail: alicesw{at}stanford.edu).

Objectives. We evaluated the effects of socioeconomic status and comorbidity on stage of disease and survival among 1,509 population-based prostate cancer patients.

Methods. We applied logistic regression and Cox proportional hazards regression to data from Whites, African Americans, and Asian Americans who were diagnosed from 1987 to 1991.

Results. Patients with existing comorbid conditions were less likely than those without these conditions to be diagnosed with advanced cancer. Compared with Whites, African Americans (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.1, 2.2) and foreign-born Asian Americans (OR = 1.6; 95% CI = 1.0, 2.4) were more likely to be diagnosed with advanced cancer. Among men with localized disease, prostate cancer death rates were higher for African Americans than for Whites (death rate ratio = 2.3; 95% CI = 1.2, 4.7).

Conclusions. These findings support the need for further investigation of factors that affect access to and use of health care among African Americans and Asian Americans.

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