International Urology and Nephrology

, Volume 51, Issue 4, pp 561–569 | Cite as

Regional trends in average years of potential life lost (AYPLL) secondary to prostate cancer deaths among Caucasians and African Americans treated by surgery or radiation

  • Mohamed H. KamelEmail author
  • Milan Bimali
  • Mahmoud I. Khalil
  • Ehab Eltahawy
  • LJoseph Su
  • Nabil K. Bissada
  • Rodney Davis
Urology - Original Paper



To study regional trends in average years of potential life lost (AYPLL) among Caucasians (CA) and African Americans (AA) with prostate cancer (Pca) who received radical prostatectomy or radiation therapy among four different regions in the US as well as across different tumor grades. Years of potential life lost is defined as the difference between a predetermined end-point age and the age at death for a death that occurred prior to that end age, hence the AYPLL is calculated by dividing the total YPLL by the total number of patients died.


The surveillance epidemiology and end results (SEER) database was used to identify Pca patients who were CA or AA and who have received radical prostatectomy or radiation therapy. Study duration was divided into four decades; 1973–1982 (D1), 1983–1992 (D2), 1993–2002 (D3), 2003–2012 (D4). Examined regions were; North East (NE), North central (NC), South and West. Tumor grade was classified into; well/moderately differentiated (WD/MD) and poorly/undifferentiated (PD/UD) groups. Differences in AYPLL among CA and AA in each of these variables were compared.


Overall, compared to CA, AA were diagnosed and died earlier from Pca. AA had higher AYPLL to Pca than CA. In both tumor grade groups, progressive increase in AYPLL among AA compared to CA was noted over the last three decades. In the WD/MD group, except for the South region, the highest recorded difference in AYPLL between AA and CA was in D4. In the PD/UD group, a similar difference in AYPLL between AA and CA was noted in all regions. The difference in AYPLL was higher in the PD/UD group than the WD/MD group.


Racial disparity between AA and CA existed across the examined regions. It is more pronounced in advanced tumor grades. The differences were more significant in the last decade.


Prostate cancer Race Years of life lost Regional Racial disparity 



African Americans


Average years of potential life lost




Gleason score


Moderately differentiated tumor


North Central


North East


Prostate cancer


Poorly differentiated tumor


Prostate-specific antigen


Undifferentiated tumor


Well-differentiated tumor


Years of potential life lost


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

11255_2019_2116_MOESM1_ESM.docx (72 kb)
Supplementary material 1 (DOCX 71 KB)
11255_2019_2116_MOESM2_ESM.docx (20 kb)
Supplementary material 2 (DOCX 19 KB)


  1. 1.
  2. 2.
  3. 3.
    Wagner SE, Bauer SE, Bayakly AR, Vena JE (2013) Prostate cancer incidence and tumor severity in Georgia: descriptive epidemiology, racial disparity, and geographic trends. Cancer Causes Control: CCC 24(1):153–166. CrossRefGoogle Scholar
  4. 4.
    Xiao H, Warrick C, Huang Y (2009) Prostate cancer treatment patterns among racial/ethnic groups in Florida. J Natl Med Assoc 101(9):936–943CrossRefGoogle Scholar
  5. 5.
  6. 6.
    Li C, Ekwueme DU, Rim SH, Tangka FK (2010) Years of potential life lost and productivity losses from male urogenital cancer deaths–United States, 2004. Urology 76(3):528–535. CrossRefGoogle Scholar
  7. 7.
    Burnet NG, Jefferies SJ, Benson RJ, Hunt DP, Treasure FP (2005) Years of life lost (YLL) from cancer is an important measure of population burden–and should be considered when allocating research funds. Br J Cancer 92(2):241–245. CrossRefGoogle Scholar
  8. 8.
  9. 9.
    Duggan MA, Anderson WF, Altekruse S, Penberthy L, Sherman ME (2016) The surveillance, epidemiology, and end results (SEER) program and pathology: toward Strengthening the critical relationship. Am J Surg Pathol 40(12):e94–e102. CrossRefGoogle Scholar
  10. 10.
    Wu XC, Yu Q, Andrews PA, Ranganath P, Qiao B, Ajani U, Wohler B, Zhang Z (2010) Comparisons of directly coded SEER Summary Stage 2000 and collaborative staging derived SEER summary stage 2000. J Regist Manag 37(4):137–140Google Scholar
  11. 11.
    Morgan TM, Welty CJ, Vakar-Lopez F, Lin DW, Wright JL (2010) Ductal adenocarcinoma of the prostate: increased mortality risk and decreased serum prostate specific antigen. J Urol 184(6):2303–2307. CrossRefGoogle Scholar
  12. 12.
    Kochanek KD, Xu J, Murphy SL, Minino AM, Kung HC (2011) Deaths: final data for 2009. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics. Natl Vital Stat Syst 60(3):1–116Google Scholar
  13. 13.
    Kamel MH, Moore PC, Bissada NK, Heshmat SM (2012) Potential years of life lost due to urogenital cancer in the United States: trends from 1972 to 2006 based on data from the SEER database. J Urol 187(3):868–871. CrossRefGoogle Scholar
  14. 14.
    Han Y, Rand KA, Hazelett DJ, Ingles SA, Kittles RA, Strom SS, Rybicki BA, Nemesure B, Isaacs WB, Stanford JL, Zheng W, Schumacher FR, Berndt SI, Wang Z, Xu J, Rohland N, Reich D, Tandon A, Pasaniuc B, Allen A, Quinque D, Mallick S, Notani D, Rosenfeld MG, Jayani RS, Kolb S, Gapstur SM, Stevens VL, Pettaway CA, Yeboah ED, Tettey Y, Biritwum RB, Adjei AA, Tay E, Truelove A, Niwa S, Chokkalingam AP, John EM, Murphy AB, Signorello LB, Carpten J, Leske MC, Wu SY, Hennis AJM, Neslund-Dudas C, Hsing AW, Chu L, Goodman PJ, Klein EA, Zheng SL, Witte JS, Casey G, Lubwama A, Pooler LC, Sheng X, Coetzee GA, Cook MB, Chanock SJ, Stram DO, Watya S, Blot WJ, Conti DV, Henderson BE, Haiman CA (2016) Prostate cancer susceptibility in men of african ancestry at 8q24. J Natl Cancer Inst. Google Scholar
  15. 15.
    Powell IJ, Bock CH, Ruterbusch JJ, Sakr W (2010) Evidence supports a faster growth rate and/or earlier transformation to clinically significant prostate cancer in black than in white American men, and influences racial progression and mortality disparity. J Urol 183(5):1792–1796. CrossRefGoogle Scholar
  16. 16.
    Schreiber D, Levy EB, Schwartz D, Rineer J, Wong A, Rotman M, Weiss JP (2014) Impact of race in a predominantly African-American population of patients with low/intermediate risk prostate cancer undergoing radical prostatectomy within an equal access care institution. Int Urol Nephrol 46(10):1941–1946. CrossRefGoogle Scholar
  17. 17.
    Lee DJ, Consedine NS, Gonzalez JR, Spencer BA (2012) Association of healthcare barriers with prostate-specific antigen screening among African-American and Afro-Caribbean men. Urology 80(3):556–563. CrossRefGoogle Scholar
  18. 18.
    Barocas DA, Grubb R III, Black A, Penson DF, Fowke JH, Andriole G, Crawford ED (2013) Association between race and follow-up diagnostic care after a positive prostate cancer screening test in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer 119(12):2223–2229. CrossRefGoogle Scholar
  19. 19.
    Mahal BA, Aizer AA, Ziehr DR, Hyatt AS, Sammon JD, Schmid M, Choueiri TK, Hu JC, Sweeney CJ, Beard CJ, D’Amico AV, Martin NE, Kim SP, Trinh QD, Nguyen PL (2014) Trends in disparate treatment of African American men with localized prostate cancer across National Comprehensive Cancer Network risk groups. Urology 84(2):386–392. CrossRefGoogle Scholar
  20. 20.
    Xu J, Janisse J, Ruterbusch J, Ager J, Schwartz KL (2016) Racial differences in treatment decision-making for men with clinically localized prostate cancer: a population-based study. J Racial Ethn Health Dispar 3(1):35–45. CrossRefGoogle Scholar
  21. 21.
    Wong AT, Safdieh JJ, Rineer J, Weiner J, Schwartz D, Schreiber D (2015) A population-based analysis of contemporary patterns of care in younger men (< 60 years old) with localized prostate cancer. Int Urol Nephrol 47(10):1629–1634. CrossRefGoogle Scholar
  22. 22.
    Chu DI, Moreira DM, Gerber L, Presti JC Jr, Aronson WJ, Terris MK, Kane CJ, Amling CL, Freedland SJ (2012) Effect of race and socioeconomic status on surgical margins and biochemical outcomes in an equal-access health care setting: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Cancer 118(20):4999–5007. CrossRefGoogle Scholar
  23. 23.
    Daskivich TJ, Kwan L, Dash A, Litwin MS (2015) Racial parity in tumor burden, treatment choice and survival outcomes in men with prostate cancer in the VA healthcare system. Prostate Cancer Prostatic Dis 18(2):104–109. CrossRefGoogle Scholar
  24. 24.
    Tyson MD, Andrews PE, Etzioni DA, Ferrigni RG, Humphreys MR, Swanson SK, Castle EK (2013) Marital status and prostate cancer outcomes. Can J Urol 20(2):6702–6706Google Scholar
  25. 25.
    White A, Coker AL, Du XL, Eggleston KS, Williams M (2011) Racial/ethnic disparities in survival among men diagnosed with prostate cancer in Texas. Cancer 117(5):1080–1088. CrossRefGoogle Scholar
  26. 26.
    Moschini M, Carroll PR, Eggener SE, Epstein JI, Graefen M, Montironi R, Parker C (2017) Low-risk prostate cancer: identification, management, and outcomes. Eur Urol 72(2):238–249. CrossRefGoogle Scholar
  27. 27.
    Grossfeld GD, Latini DM, Downs T, Lubeck DP, Mehta SS, Carroll PR (2002) Is ethnicity an independent predictor of prostate cancer recurrence after radical prostatectomy? J Urol 168(6):2510–2515. CrossRefGoogle Scholar
  28. 28.
    Chen Y-W, Mahal BA, Muralidhar V, Nezolosky M, Beard CJ, Den RB, Feng FY, Hoffman KE, Martin NE, Orio PF, Nguyen PL (2016) Association between treatment at a high-volume facility and improved survival for radiation-treated men with high-risk prostate cancer. Int J Radiat Oncol Biol Phys 94(4):683–690. CrossRefGoogle Scholar
  29. 29.
    Moses KA, Orom H, Brasel A, Gaddy J, Underwood W III (2016) Racial/ethnic differences in the relative risk of receipt of specific treatment among men with prostate cancer. Urol Oncol 34(9):415. (e412–415, e417)CrossRefGoogle Scholar
  30. 30.
    Wang C, Raldow A, King CR, Kupelian PA, Nickols N, Chang AJ, Steinberg ML, Spratt DE, Nguyen PL, Kishan AU (2018) Racial disparity in androgen deprivation therapy utilization for men with high-risk prostate cancer treated with intensity-modulated radiation therapy in the modern era—a SEER-medicare linked database analysis. Int J Radiat Oncol Biol Phys 102(3):e147–e148. Google Scholar
  31. 31.
    Trinh Q-D, Sun M, Sammon J, Bianchi M, Sukumar S, Ghani KR, Jeong W, Dabaja A, Shariat SF, Perrotte P, Agarwal PK, Rogers CG, Peabody JO, Menon M, Karakiewicz PI (2012) Disparities in access to care at high-volume institutions for uro-oncologic procedures. Cancer 118(18):4421–4426. doiCrossRefGoogle Scholar
  32. 32.
    Bul M, van den Bergh RC, Zhu X, Rannikko A, Vasarainen H, Bangma CH, Schroder FH, Roobol MJ (2012) Outcomes of initially expectantly managed patients with low or intermediate risk screen-detected localized prostate cancer. BJU Int 110(11):1672–1677. CrossRefGoogle Scholar
  33. 33.
    Thompson I, Tangen C, Tolcher A, Crawford E, Eisenberger M, Moinpour C (2001) Association of African-American ethnic background with survival in men with metastatic prostate cancer. J Natl Cancer Inst 93(3):219–225CrossRefGoogle Scholar
  34. 34.
    Qi R, Moul J (2017) African American men with low-risk prostate cancer are candidates for active surveillance: the will-rogers effect? Am J Men Health 11(6):1765–1771. CrossRefGoogle Scholar
  35. 35.
    Schreiber D, Chhabra A, Rineer J, Weedon J, Schwartz D (2015) A population-based study of men with low-volume low-risk prostate cancer: does African-American race predict for more aggressive disease? Clin Genitourin Cancer 13(4):e259–e264. CrossRefGoogle Scholar
  36. 36.
    Leapman MS, Freedland SJ, Aronson WJ, Kane CJ, Terris MK, Walker K, Amling CL, Carroll PR, Cooperberg MR (2016) Pathological and biochemical outcomes among African-American and Caucasian men with low risk prostate cancer in the SEARCH database: implications for active surveillance candidacy. J Urol 196(5):1408–1414. CrossRefGoogle Scholar
  37. 37.
    Dosemeci M, Hoover RN, Blair A, Figgs LW, Devesa S, Grauman D, Fraumeni JF Jr (1994) Farming and prostate cancer among African-Americans in the southeastern United States. J Natl Cancer Inst 86(22):1718–1719CrossRefGoogle Scholar
  38. 38.
    Blair A, Fraumeni JF (1978) Geographic patterns of prostate cancer in the United States. J Natl Cancer Inst 61(6):1379–1384Google Scholar
  39. 39.
    Meliker JR, Goovaerts P, Jacquez GM, Avruskin GA, Copeland G (2009) Breast and prostate cancer survival in Michigan: can geographic analyses assist in understanding racial disparities? Cancer 115(10):2212–2221. CrossRefGoogle Scholar
  40. 40.
    Kristal AR, Till C, Song X, Tangen CM, Goodman PJ, Neuhauser ML, Schenk JM, Thompson IM, Meyskens FL Jr, Goodman GE, Minasian LM, Parnes HL, Klein EA (2014) Plasma vitamin D and prostate cancer risk: results from the selenium and Vitamin E cancer prevention trial. Cancer Epidemiol Biomarkers Prev 23(8):1494–1504. CrossRefGoogle Scholar
  41. 41.
    Reinstatler L, Carmichael D, Austin AM, Goodney PP, Bynum JP, Hyams ES (2018) Regional variation in the intensity of prostate cancer care: a study of a large medicare sample. Int J Urol 25(11):974–975. CrossRefGoogle Scholar
  42. 42.
    Moses KA, Orom H, Brasel A, Gaddy J, Underwood W III (2017) Racial/ethnic disparity in treatment for prostate cancer. Does cancer severity matter? Urology 99:76–83. CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of UrologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  2. 2.Department of BiostatisticsUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.Department of EpidemiologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  4. 4.Department of UrologyBaylor School of Medicine and Michael E. De Bakey VA Medical centerHoustonUSA
  5. 5.Department of UrologyAin Shams UniversityCairoEgypt

Personalised recommendations