Prostate Cancer: Black-White Race Gap

When it comes to diagnosing prostate cancer at an early
stage, black men's biggest hurdle may be poor access to trusted medical
care.

So say researchers including James Talcott, MD, SM, of the Center for
Outcomes Research at Massachusetts General Hospital.

They studied 555 men -- 348 whites and 207 blacks -- newly diagnosed with
prostate cancer and living in North Carolina.

The men completed surveys about their medical history, personal backgrounds,
access to medical care, and trust in doctors.

The study shows that black men knew about their risk but faced disadvantages
in access to medical care.

Better access to medical care may help black men get diagnosed with prostate
cancer sooner, the researchers note.

Aware of Risk

The study appears in the April 15 edition of Cancer.

The patients were at least 41 years old. Blacks tended to be younger than
whites.

Black men were more likely to have lower-income jobs, no health insurance,
and blue-collar jobs. They were also more likely to get their medical care in
emergency rooms, not doctors' offices.

Black men are more likely than white men to die of prostate cancer, and the
black men in this study reported knowing that they were at increased risk for
prostate cancer before diagnosis.

Paul Godley, MD, PhD, worked with Talcott and colleagues on the study.
Godley is on staff at the schools of public health and medicine at the
University of North Carolina at Chapel Hill.

"African American men were aware of their increased risk of prostate
cancer, and they felt responsible for getting themselves to physicians for
preventative care. But there were substantial barriers to their carrying out
what they saw as being important," Godley says in a UNC news release.

Distrust of Doctors

Most men -- black or white -- expressed trust in their doctors. But 85% of
black men reported 'completely" or "mostly" trusting their doctors,
compared with 96% of white men.

That may be because black men were more likely to go to emergency rooms for
medical care, where they might not always see the same doctor, the researchers
note.

"If you don't have a doctor and have to repeat your whole history to an
emergency room physician every time you have a medical encounter, then it's
harder to develop trust in physicians," Godley says. "Lack of trust
seemed to stem from the lack of a regular source of health care.

Cultural suspicion of doctors and medical care didn't seem to be a big issue
among the black men.

"This wasn't coming from some historical distrust from previous abuses
but was coming from people's own experience with the health care system,"
Godley says.

Black men were also more likely than whites to say they requested prostate
cancer screening, while whites generally said their doctors recommended
prostate cancer screening tests. The reasons for that race gap aren't
clear.

"The reassuring part of the findings is that measures to generally make
health care more accessible would also potentially address some of the
disparities in prostate cancer," Godley says.

By
Reviewed by Louise Chang
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