Underprivileged men more likely to receive advanced prostate cancer diagnoses

Low-income men are more likely to present with advanced prostate cancers, most likely because they do not receive screening services shown to reduce the diagnosis of later-stage cancers, according to a study by UCLA researchers.

The study focused on a group of disadvantaged men enrolled in the state’s IMPACT (Improving Access, Counseling and Treatment for Californians with Prostate Cancer) program, which provides high-quality care to poor, underinsured, and uninsured men.

Researchers found that of the 570 men studied, 19% had metastatic cancer at diagnosis, compared with 4% of men from the general population who were followed in other studies.

The study, which was published in the Journal of Urology (2009; 181:579-84), also found that diagnosis rates for lower-risk, less advanced cancers in the IMPACT patients did not increase over time, while the diagnosis rates of lower-risk, less advanced cancers did go up for men in more affluent populations.

“The IMPACT program, without question, allows these disadvantaged men to receive high-quality prostate cancer care that they did not have access to before,” said senior author William Aronson, MD. “However, the persistent preponderance of metastatic and higher-risk localized cancers in these men suggests that more comprehensive strategies are needed to eliminate the disparities in prostate cancer morbidity and mortality.”