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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

  • Urology - Original Paper
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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

AA:

African Americans

AYPLL:

Average years of potential life lost

CA:

Caucasians

GS:

Gleason score

MD:

Moderately differentiated tumor

NC:

North Central

NE:

North East

Pca:

Prostate cancer

PD:

Poorly differentiated tumor

PSA:

Prostate-specific antigen

UD:

Undifferentiated tumor

WD:

Well-differentiated tumor

YPLL:

Years of potential life lost

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Authors and Affiliations

  1. Department of Urology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA

    Mohamed H. Kamel, Mahmoud I. Khalil, Ehab Eltahawy & Rodney Davis

  2. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Milan Bimali

  3. Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    LJoseph Su

  4. Department of Urology, Baylor School of Medicine and Michael E. De Bakey VA Medical center, Houston, TX, USA

    Nabil K. Bissada

  5. Department of Urology, Ain Shams University, Cairo, Egypt

    Mohamed H. Kamel, Mahmoud I. Khalil & Ehab Eltahawy

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Correspondence to Mohamed H. Kamel.

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Kamel, M.H., Bimali, M., Khalil, M.I. et al. 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. Int Urol Nephrol 51, 561–569 (2019). https://doi.org/10.1007/s11255-019-02116-2

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