The co-authors of Invasion of the Prostate Snatchers, blog alternate posts weekly. We invite you to post your comments.

Tuesday, April 21, 2015

African-Americans and Prostate Cancer


The hard fact is that the death rate from undiagnosed prostate cancer for African-Americans is currently more than twice that for Caucasian men. Although scientists do not yet fully understand why this is so, it is widely believed that genetic differences, lifestyle, reluctance to undergo digital-rectal testing, and nutritional habits all play a role in these statistics. Which is why all African-Americans are urged to begin tests at an earlier age (40) regardless of their health history.

While African-American men are already at an increased risk for prostate cancer, that risk goes up even further if there is a family history of the disease. African-American men, with an immediate family member who had prostate cancer before age 65, have a one-in-three chance of developing the disease. With two family members involved, that risk rises to over 80%. This is why prostate cancer screening at a younger age is vital because by the time that symptoms appear, the cancer is more likely to be at an advanced stage.

The differences in prostate cancer diagnosis and treatment seem to account for a significant portion of the gap in death rates between blacks and whites.  First, black men are less likely than whites to have adequate insurance. Uninsured men have lower rates of screening and are less likely to see a health care professional. These men are more likely to be diagnosed with advanced disease –cancer that has spread outside of the prostate gland. It is worth noting that studies of blacks and whites in the military, where men have equal access to health care services, have shown that this equal access eliminates of most of the death rate gap.

So what can African-American men and their health care professionals do right now?  The advice is the same for black men as for all other men. Focus on early diagnosis through PSA screening.  The controversies about PSA screening are mostly related to over diagnosis of low-grade disease.  Many of these low-grade cancers don’t even need to be treated. They can be safely watched. And that fear can largely be address by evaluating an abnormal PSA finding with a MRI scan rather than a 12-core random biopsy.  Given the extremely high rates of prostate cancer in African-American men, getting a PSA test represents a simple but potentially life-saving act.

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