OBJECTIVES : We sought to describe disparities in additional surgical procedures up to 5 years after initial treatment for localized prostate cancer.

METHODS : We analyzed localized prostate cancer cases reported in 2004–2013 to Surveillance, Epidemiology and End Results (SEER) cancer registries, and linked with Medicare claims. We used a Cox regression model to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for receipt of additional surgical procedures up to 5 years after initial treatment, adjusting for: the type of initial treatment; SEER race/ethnicity; age group; Gleason score; Charlson comorbidity score; and procedures prior to initial treatment.

RESULTS : Our final study cohort included a total of 111,069 men with localized prostate cancer, with 86,798 non-Hispanic white, 11,032 non-Hispanic black, 3,955 non-Hispanic Asian or Pacific Islanders (APIs), and 6,454 Hispanic any race. During follow-up after initial treatment, after adjustment, non-Hispanic blacks were less likely than non-Hispanic whites to receive cystoscopy (HR, 0.939; 95% CI, 0.893-0.987) and more likely to receive urethral dilation (HR, 1.130; 95% CI, 1.049-1.217) or bladder irrigation/cystotomy (HR 1.094; 95% CI, 1.002-1.194). Non-Hispanic APIs were less likely than non-Hispanic whites to receive artificial urinary sphincter (HR, 0.607; 95% CI, 0.411-0.897), cystoscopy (HR, 0.805; 95% CI, 0.740-0.875), urethral dilation (HR, 0.751; 95% CI, 0.653-0.863), TURP/bladder neck procedures (HR, 0.698; 95% CI, 0.561-0.869), or bladder irrigation/cystotomy (HR, 0.636; 95% CI, 0.531-0.760). Hispanics of any race were more likely than non-Hispanic whites to receive urethral dilation (HR, 1.125; 95% CI, 1.026-1.233).

CONCLUSIONS : Racial-ethnic disparities were present in additional surgical procedures up to 5 years after initial treatment for localized prostate cancer during 2004-2013.