{"doi":"10.1002/cncr.33064","title":"Reply to Equal access to health care reduces racial disparities in prostate cancer outcomes and Access and socioeconomic status play an important role in outcomes for African American patients with prostate cancer","abstract":"We would like to thank Lundon et al and Hoge et al for their insightful letters and research contributions to this field.1, 2 Our work3 has built on a large body of literature suggesting that socioeconomic factors and access to medical care are the primary drivers of poorer outcomes for African American men with prostate cancer. Our study added to this work by pointing toward a solution that is working in practice throughout the United States, suggesting that poorer outcomes for African American men with prostate cancer do not need to be a foregone conclusion. As optimistic as our study and the study from Dess et al4 appear to be at first glance, the work of eliminating racial disparities in prostate cancer is far from done. Today, the average African American man still is more than twice as likely to die of prostate cancer5 than the average non-Hispanic white man. Historically, this disparity was believed to arise from inherently more aggressive prostate cancers diagnosed in African American men. Our work and the work of others1 do not support this hypothesis. Instead, this disparity appears to arise from 2 main factors. First, barriers to high-quality medical care appear to lead to delayed diagnosis and substandard treatment in some settings. We and others have shown that this can be a surmountable obstacle, although one that will require extensive efforts. Further work is required to identify the specific aspects of care that are effective in reducing disparities2 and to implement these care strategies in the broader health care system. Second, African American men are 78% more likely to be diagnosed with prostate cancer.5 Disparities in health care such as decreased prostate-specific antigen screening would not be expected to increase the incidence of the disease. As such, there appears to be a true biologic reason that African American men are at a higher risk of developing prostate cancer and therefore are at a higher risk of death from prostate cancer. Addressing the causes of this increased incidence and providing equal care to those diagnosed with the disease ultimately will be the only way to achieve equal outcomes for African American men who are diagnosed with prostate cancer. Supported by the National Institutes of Health (grant TL1-TR001443 to Paul J. Riviere) and the Department of Defense (grant W81XWH-17-PCRP-PRA to Brent S. Rose). The sponsors had no role in the design or writing of this article. Paul J. Riviere has acted as a paid consultant for Peptide Logic LLC for work performed outside of the current study. Brent S. Rose made no disclosures.","journal":"Cancer","year":2020,"id":122885,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9527,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":263871,"name":"Brent S. Rose","orcid":"0000-0002-3197-9552","position":1,"is_corresponding":false},{"id":263864,"name":"Paul Riviere","orcid":"0000-0001-7966-3090","position":0,"is_corresponding":true}],"reference_count":6,"raw_metadata":null,"created_at":"2026-07-18T23:14:55.385653Z","pmid":"32644210","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}