For decades, black or African American race has been associated with worse outcomes for a number of diseases. Indeed, the cancer literature is replete with findings that breast, colon, and prostate cancers are more aggressive in black than white patients.1 Such findings have raised the question of whether being African American imparts a worse prognosis for these diseases. In some cases, such findings have even influenced legislation. For example, they are the reason why the National Institutes of Health Revitalization Act of 1993 requires including minorities in large federally sponsored clinical trials and conducting valid subset analysis of outcomes by race.2 In this issue of JAMA Oncology, the report by Dess et al3 is an excellent example of how to appropriately analyze this question of the association between race and disease prognosis and adds to the growing body of evidence that race-defining biological differences do not explain prostate cancer health inequalities.
Paller CJ, Wang L, Brawley OW. Racial Inequality in Prostate Cancer Outcomes—Socioeconomics, Not Biology. JAMA Oncol. Published online May 23, 2019. doi:10.1001/jamaoncol.2019.0812
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