Twenty-nine studies (n=24,968) were included: 3 randomised controlled trials (n=3,661) and 26 retrospective studies of unspecified design.
Studies controlled for different confounders. Just under half of the studies (46%) controlled for age of onset, stage and grade of disease. Most studies did not report controlling for socioeconomic status and family history.
Twenty-three studies (79%) found no relationship between race and treatment outcomes.
There was no difference in outcomes for 10 (77%) of 13 studies assessing PSA failure or for 8 (73%) of 11 studies assessing overall or disease-free or disease-specific survival. Six studies (21%) found that the outcomes were worse among black men. Studies reporting a difference were more likely to be published in 1996 or before, to be in patients with metastatic disease, and were less likely to use radiotherapy treatment than studies reporting no difference.
No study found that white men had worse outcomes than black men.