Is It True That African American Men At More Risk From Prostate Cancer Than White Men?

Figures show that African American men are more likely to die from prostate cancer than white men and the majority of statisticians are in agreement that the risk in the case of African Americans is about two and a half times that of white men. But, are these figures misleading?

The answer to this question may be found in a study conducted recently in North Carolina. The study looked at some 253 white men and 84 African Americans between the ages of 40 and 75 who were diagnosed with prostate cancer between 2001 and 2004.

The study looked at several factors including screening history, the existence of other medical conditions, symptoms, attitudes towards health care and health care providers, access to care, income, treatment, family history, employment and whether the men had health insurance.

The study found that 55 percent of the African Americans earned under $40,000 annually in comparison to to 23 percent for the white men. It also found that African Americans were more likely to be less well educated, to have a blue-collar job, to have other accompanying medical problems and to be unemployed through disability or illness.

Additionally, the study found that only 3 percent of white men had no medical insurance at all, compared to 8 percent of African Americans and that just over 30 percent of white men has some type of supplemental Medicare coverage, compared to 17 percent of African Americans.

One especially interesting finding was the fact that both groups of men were well informed about the risks of prostrate cancer and the need for treatment, but that the African Americans accepted more responsibility for their own health and were not as likely to trust their doctors. Indeed several of the African Americans said that they were suspicious of their doctors and felt that any advice given was more likely to be influenced by the cost of treatment than it was to be based upon patient needs.

On the important question of screening, African Americans were less likely to have regular check-ups, digital rectal examinations or prostate specific antigen (PSA) tests. The study also reported that African Americans were far more likely to have to request a PSA test than white men.

The study makes it clear that there is a marked different between the two groups that lies in the lack of early detection in the case of African Americans and that this arises to a significant degree from the fact that they do not have sound relationships with their physicians, have poor access to convenient and affordable care and do not carry adequate health insurance.

Quite clearly it is difficult to assign numbers to a study of this type and further, and bigger, studies should to be conducted to quantify the differences between African Americans and white men. Nonetheless, it would appear that much of the difference does not stem from the fact that African Americans are more likely to develop prostate cancer but stems from the fact that they are more likely to die from the disease because of its late detection.

If the gap between the two groups as far as the provision of healthcare were narrowed then the figures might well look very different.

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