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Purpose: We sought to determine if there were racial/ethnic disparities in the receipt of initial, cure-intended treatment for localized prostate cancer. Methods: We analyzed prostate cancer cases reported in 2004-2013 to Surveillance, Epidemiology and End Results (SEER) cancer registries, linked with Medicare claims from 2003-2014. We focused on cases that were fee-for-service with continuous Part A and B Medicare from 12 months before first diagnosis to 6 months after diagnosis, and that had American Joint Committee on Cancer 6th Edition tumor extent T1 or T2 without metastatic disease. We used SEER race/ethnicity to categorize cases as non-Hispanic whites; non-Hispanic blacks; non-Hispanic Asian or Pacific Islanders; Hispanics of any race; and Other/Unknown. We defined initial treatment to include 1 month before to 6 months after first diagnosis; cure-intended radical prostatectomy to include radical prostatectomy with or without radiation therapy; cure-intended radiation therapy to include radiation therapy without a radical prostatectomy; and noncurative treatment to include other initial treatment or no treatment. We used multivariable logistic regression to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for receipt of each category of initial treatment, compared with the remaining cases, and adjusting for race/ethnicity; life expectancy from the man's age at diagnosis; pretreatment prostate cancer disease recurrence risk category; Charlson comorbidity score; year of diagnosis; SEER registry region, census tract poverty; and metropolitan or nonmetropolitan county location. Results: Our final study cohort included a total of 125,072 men, with 95,763 non-Hispanic white, 13,616 non-Hispanic black, 4,658 non-Hispanic Asian or Pacific Islanders, 7,933 Hispanic any race, and 3,102 in the Other/Unknown category. After adjustment for multiple variables, non-Hispanic blacks were less likely than non-Hispanic whites to receive initial radical prostatectomy (with or without radiation therapy) (OR, 0.57; 95% CI, 0.53-0.61) or initial radiation therapy without radical prostatectomy (OR, 0.85; 95% CI, 0.82-0.88), and more likely to receive noncurative treatment (OR, 1.51; 95% CI, 1.45-1.57). Non-Hispanic Asian or Pacific Islanders were more likely than non-Hispanic whites to receive initial radiation therapy without radical prostatectomy (OR, 1.23; 95% CI, 1.16-1.31), and less likely to receive noncurative treatment (OR, 0.84; 95% CI, 0.78-0.89). The adjusted odds ratios for curative and noncurative initial treatment received by Hispanics of any race were similar to those for non-Hispanic whites. Conclusion: Compared with non-Hispanic whites, non-Hispanic black men were less likely to receive curative and more likely to receive noncurative initial treatment for localized prostate cancer during 2004-2013. Citation Format: Thomas B. Richards, David G. Stinchcomb, Timothy S. McNeel, Wilhelmina Ross, Diane Ng. Racial-ethnic disparities in the receipt of initial, cure-intended treatment for localized prostate cancer, SEER Medicare, 2004-2013 [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B023.

Adults 65 and older are at greatest risk for complications and death from influenza, yet one third of those at risk do not receive the influenza vaccine; African American vaccination rates are even lower. This study explored older African Americans' concerns about getting the flu vaccine and vaccine providers' level of awareness of these concerns.Focus groups and in-depth interviews were conducted among African Americans who were 50 years of age and older, and vaccine providers.Older African Americans' fear of getting the flu from vaccination was widespread, as were concerns about vaccine interaction with medications and allergic reactions. Older African Americans also doubted the vaccine's effectiveness, and distrusted both the vaccine and the healthcare system. For their part, providers understood patients' concerns and recognized that fear of illness caused by the shot was a major issue. They did not, however, recognize the importance of asking about, and discussing, patients' fears of allergies and medication interactions when administering the vaccine.In order to improve vaccination rates among older African Americans, health care providers would be wise to take the time to discuss the vaccine and address vaccine efficacy, safety, side effects, and drug interactions.