Race, poverty related to prostate cancer outcomes

February 16, 2006

Only 25% of African-American men ages 60 to 69 years undergo PSA screening and 36% receive annual digital rectal exams, while just under 50% of African-Americans at high risk for the disease (those with a family history) undergo PSA tests and 38% receive DREs, according to a study published in Cancer (2006; 106:796-803).

Only 25% of African-American men ages 60 to 69 years undergo PSA screening and 36% receive annual digital rectal exams, while just under 50% of African-Americans at high risk for the disease (those with a family history) undergo PSA tests and 38% receive DREs, according to a study published in Cancer (2006; 106:796-803). By comparison, 81% of Caucasian males of the same age undergo PSA tests and 68% receive DREs.

Prior research has shown that African-American men have a 50% higher incidence of prostate cancer and more than double the mortality rate of Caucasian men. This research further suggests a glaring health disparity with access to health care and economics as key factors, said lead author Sally Weinrich, MD, of the Medical College of Georgia, Augusta.

“African-American men have the right to be informed about prostate cancer screening options,” she said. “We need additional research to study the reasons why African-American men with a positive family history have lower screening rates than African-American men in general.”

A separate study to be published in the March 15 issue of Cancer suggests that race plays a minor role in prostate cancer survival, and that the most important explaining disparities in outcomes were education, community poverty, and income levels. Age, disease stage, and treatment method also independently impacted outcome.

The researchers found that in men with local or regional prostate cancer, lower socioeconomic status was significantly associated with decreased survival, even after controlling for other patient/tumor characteristics and treatment. The study also identified “racial and ethnic disparities in survival, but these disparities reduced substantially after controlling for socioeconomic factors,” according to the authors, led by Xianglin L. Du, PhD, of the University of Texas School of Public Health, Houston.