By Jill Pease
Where a patient lives and receives prostate cancer treatment plays an important role in treatment inequities, but it’s not the only factor, finds a new University of Florida College of Public Health and Health Professions study published in the Journal of the National Cancer Institute.
“Our study highlights significant treatment inequities in prostate cancer care between Black and white individuals,” said lead author Noah Hammarlund, Ph.D., an assistant professor in the PHHP Department of Health Services Research, Management and Policy. “We found that while where patients live and receive care impacts these disparities, racial factors that reflect broader social and systemic inequities, still play a strong independent role.”
The study was conducted as part of Hammarlund’s ongoing research to understand and dismantle barriers to equitable care so that all patients receive appropriate and effective treatments. In the case of prostate cancer, Black patients are less likely to receive treatment and more than twice as likely to die of the disease compared with white patients. The new study was designed to understand the role of patient residence and location of treatment and how that may impact the prostate cancer care they receive.
For the study, Hammarlund and colleagues at the University of Washington and the Fred Hutchinson Cancer Research Center, evaluated data from the Surveillance, Epidemiology, and End Results, or SEER, cancer registry, which is linked to Medicare claims data. Among a sample of more than 18,000 patients who were diagnosed with prostate cancer, the team analyzed factors including patient and hospital zip code and the treatment patients received.
Their results indicate that residential location-related factors explain only half of the treatment inequities experienced by Black patients, who were less likely to receive a prostate cancer therapy known as radical prostatectomy.
“The persistence of treatment inequities, despite accounting for structural factors like location and health care access, was surprising,” said Hammarlund, a member of the UF Health Cancer Center. “This underscores the complex interplay of race and health care, suggesting that systemic racism still significantly influences health care outcomes.”
The findings offer insights for both policymakers and health care providers, such as the need for interventions that target structural barriers to health care access and the impacts of racial biases in health care settings, and the importance of collaboration between providers and patients, Hammarlund said.
“By fostering trust, improving communication and addressing barriers to care, providers can help empower patients to make informed decisions and ensure treatment plans align with their needs and preferences,” he said.
Hammarlund’s study was published as part of the Journal of the National Cancer Institute’s Early Career Investigator Research Section, which launched in 2024 and is devoted to publishing manuscripts authored by early career investigators.
“The section provided a platform specifically designed to support and highlight the work of emerging researchers,” Hammarlund said. “It offers significant visibility and support for early career researchers, which can be instrumental in establishing oneself in the field.”
Efforts to prioritize early career researcher submissions are one way journals can foster a new generation of scientists, Hammarlund said, along with expedited review processes, constructive reviewer feedback and expanded opportunities for early career researchers to participate in editorial activities.
“By integrating early career researchers more into the publication process, journals can help cultivate a more diverse research community that supports fresh perspectives and innovative ideas,” Hammarlund said.