Ethnic/Racial Variation in Prostate Cancer Net Survival: A Systematic Review

Background Prostate cancer (PC) is the second most common cancer affecting men worldwide, with incidence and survival varying across ethnic/racial groups. Most evidence on ethnic PC survival in population studies is based on overall, progression-free and cause-specific approaches. No reviews examined ethnic disparities in PC net survival (NS) when assessed within relative survival (RS) framework . Methods We systematically reviewed studies examining PC net survival by ethnicity/race. We searched MEDLINE, Web of Science and Embase databases for articles published from 01-January-2010 to 28-February-2025. Five-year net survival differences (NSD) were summarized using forest plots and narrative synthesis. Results Twenty-six studies met inclusion criteria, twenty of which were conducted in the United States (US). White men had higher net survival than Black (13/18 studies: Range: NSD: 1% to 6% ), Asian/Pacific Islander (5/5 studies: Range: NSD: 2.8% to 6% ), Indian/Alaska Natives (6/6 studies, Range: NSD: 2% to 7% ), and Hispanic men (5/5 studies: Range: NSD: 2.6% to 6%). Conclusions White men have higher PC net survival than minority ethnic groups in US and effort should focus on addressing the inequalities. Studies in equal-access healthcare settings are needed to guide international policy. PROSPERO ID: CRD420251042423