Session: PD20: Diversity, Equity & Inclusion: Health Equity & Outcomes III
PD20-02: Underrepresentation of Racial and Ethnic diversity in the Literature informing the 2022 American Urological Association/American Society of Radiation Oncology/Society Guideline on Clinically Localized Prostate Cancer
Introduction: The relationship between race and prostate cancer is complex. African American patients with prostate cancer are more likely to present with more advanced prostate cancer compared to their white counterparts. This may be associated with genetic differences but are also attributed to socioeconomic status and reduced access to healthcare. It follows that guideline informing data should a) include baseline demographic data including race and ethnicity and b) demographics should include a diverse patient population that is generalizable across racial and ethnic populations. The purpose of our study is to investigate and characterize the demographic representation in the literature that was cited in the 2022 American Urological Association guidelines on clinically localized prostate cancer. Methods: Research that was cited by the guideline were reviewed based on a set of inclusion and exclusion criteria. Studies included were based in the United States and included patient demographics and patient ethnicity and race. Results: We reviewed the 297 studies cited in the AUA guideline. After excluding 166 studies based on our predetermined exclusion criteria, we included 131 studies in our further analysis. Of these, 68 studies were based exclusively in the U.S. Of the 68 U.S.-based studies, 35 (51.5%) reported racial demographic data. Of these, 9 (25.7%) were randomized controlled trials, 18 were retrospective cohort studies (51.4%), 11 were prospective cohort studies (31.4%), and the 1 remaining was a cross-sectional study (4%). Of these studies that reported racial data, 21 (60.0%) reported race as either white/Caucasian, black/African American, or other/unknown. Overall of these studies that included race, 81.7% of patients were white/Caucasian, 9.9% were black/African American, and 8.4% were other/unknown including Hispanic and Asian. Conclusions: The vast majority of the research used in the establishment of the most recent guidelines on clinically localized prostate cancer did not include patient racial demographics. In the studies that included race, the majority only provided information on white/Caucasian and black/African American patients and did not capture other racial categories such as Hispanic or Asian. Overall, white/Caucasian patients were greatly overrepresented in relation to black/African American patients while Hispanic and Asian patients were underrepresented or categorically excluded. SOURCE OF Funding: None
