Since the early 2000s, robot-assisted radical prostatectomy (RARP) has been rapidly adopted in prostate cancer treatment. It is associated with improved short- and long-term outcomes and comparable long-term survival. However, research shows that Black and Hispanic prostate cancer patients are less likely to receive RARP than white patients, leading to disparities in their health outcomes.
A study in JNCI Cancer Spectrum from Dr. Jialin Mao, assistant professor of population health sciences, investigates how surgeon treatment patterns relate to racial and ethnic disparities in RARP use among prostate cancer patients. The first hypothesis posits that Hispanic and non-Hispanic Black patients are less likely to be treated by surgeons who are high-RARP users compared with non-Hispanic White patients. The second hypothesis posits that Hispanic and non-Hispanic Black patients are less likely to receive RARP than non-Hispanic White patients despite having similar conditions and being treated by the same surgeon.
Researchers used data from the New York State Cancer Registry linked to the Statewide Planning and Research Cooperative System. These account for cancer characteristics, sociodemographic information, insurance status, and more.
Results show that data is consistent with both hypotheses, indicating that treatment patterns contribute to disparities in care and outcomes. Researchers suggest that racial and ethnic disparities in RARP use arise through access to care and the process of care at the physician level. Additionally, racial and ethnic minority groups likely face systematic barriers when it comes to accessing technology-adopting physicians. There may be conscious and unconscious biases embedded in our health care system about patients’ cooperativeness or attitudes toward robot technology, which in turn affects physicians’ treatment decisions.
“This study shows that a lot of the inequities in health care happen on the structural level,” explained Dr. Mao, “emphasizing the need to act from there. Moving forward, we need to understand why this is happening and what we can do to dismantle the existing barriers.”
- Highlights