b'Metastatic Castration-Sensitive Prostate Cancer Race AnalysisSource: Emerging racial disparities among Medicare beneficiaries and veterans with metastatic castration-sensitive prostate cancer. Prostate Cancer Prostatic Dis. 2024 Apr 2. doi: 10.1038/s41391-024-00815-1.for white patients. Among veterans the proportionsome questions among the researchers. In connection receiving TI increased from 9.7% in 2015 to 28.0%with the disparity among veterans, lead author Daniel in 2019 for Black patients and from 8.9% to 29.8%J. George, MD, told U.S. Medicine, I was surprised for white patients. that with equal insurance, that there was a difference After adjustment for patient characteristics, Blackin terms of intensification rates. One factor might be patients with Medicare alone were 30% less likely toother nonclinical differences that may associate with receive TI than their white counterparts. Among dual- race, including social determinants of health.enrolledbeneficiaries,therewasnodifferencebyAs to the lack of difference in overall survival rates race, but all those with Medicaid were 33% less likelyamongveteransdespiteadifferenceintreatment than those with Medicare only to receive TI. intensification rates, George noted, We focused only On an adjusted basis, Black veterans were 25% lessonpatientswithmetastaticprostatecancer,sothe likelytoreceiveTIthanwhiteveterans,buttheredifferencesinratesofaggressivenessbyracemay was no significant difference in median overall sur- be negated when we eliminated patients with non-vival on an adjusted or unadjusted basis, 43.6 (38.1- metastatic prostate cancer (more commonly in white 50.3) months for Black veterans and 42.2 (39.7-45.5)patients). Next, focusing on the metastatic setting, the months for white veterans. early deaths may be driven by the most aggressive Given that prostate cancer tends to be more aggres- cancers in both races where the disease is not solely sive in Black patients, the lower levels of TI raiseddependent on hormonal signals. I suspect that over 57'