BY RALPH BLUM
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.