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Racial differences again seen in prostate cancer
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Early testing should begin at age 45
African American men suffer the world's highest prostate cancer incidence and mortality rates. They have a 60% higher incidence of prostate cancer than all other populations, resulting in a 150% higher mortality rate. Furthermore, Black men with prostate cancer, compared with their White counterparts, have a poorer prognosis that is not fully explained by other "co-morbid" illnesses, or by different screening rates or access to health care according to a report in the International Journal of Cancer.
Some of the differences in prostate cancer mortality may reflect less aggressive management among African American men, particularly older men. However, according to experts, even in the presence of optimal care of equal standard for both Black and White men, there remain differences due to underlying biological factors.
According to the US Census Bureau, more than 30,000 cases of prostate cancer occurred among African American men in 2005, accounting for approximately 42% of all cancers diagnosed in this population. Between 1997 and 2001, the prostate cancer incidence rate was on average 60% higher in African American men than in white men.
The American Cancer Society statistics on cancer for African Americans states prostate cancer is the second leading cause of cancer deaths. They have the highest mortality rate of any ethnic and racial group in the US. The death rate from prostate cancer is 2.4 times higher in African Americans than in white men.
The overall five year relative survival rate for prostate cancer among African Americans was 96% for the years 1995 to 2000, compared to close to 100% among whites. Eighty-eight percent of all prostate cancers among African Americans are diagnosed at the localized and regional stages compared to 91% in whites; the five year relative survival rate for African Americans who are diagnosed at these stages is close to100%. The five year survival rate drops to 29% when the cancer has spread to distant sites.
African Americans are more likely to be diagnosed at a later stage of cancer than whites, possibly due to factors such as less knowledge about cancer symptoms and reduced access to cancer screening services. Later stage at detection, in turn, contributes to lower cure rates and shorter survival.
Prostate Cancer Early Detection Guidelines
- The prostate specific antigen (PSA) test and the digital rectal exam (DRE) should be offered annually beginning at age 50 to men
- African American men should begin testing at age 45
- African American men with multiple first degree relatives with prostate cancer should begin screening at age 40
- Men who request to be tested should not be denied testing
- Men who request the physician to make the decision for them should be screened
Source: Adapted from the American Cancer Society
Currently there is research being conducted as well as programs to reduce cancer disparities. The Special Populations Networks/Community Networks Program is an initiative of the National Cancer Institute to address the unequal burden of cancer within certain special populations in the United States. This is done by awarding grants to researchers for public health projects that focus on communities nationwide.
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