Black men are twice as likely to develop prostate cancer as whites

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Jan. 19, 2022 (HealthDay News) — Even in an environment where whites and blacks have equal access to medical care, black Americans are doing worse than whites in prostate cancer, new research shows.

A survey of nearly 8 million men seen in America’s Veterans Affairs (VA) hospitals found that black veterans were nearly twice as likely to have localized and advanced prostate cancer as white men.

But there was a glimmer of good news: When given the same treatment, black and white men had similar results.

Importantly, African American men who received definitive primary treatment had a lower risk of [cancer spreading]said co-author Dr. Isla Garraway, an associate professor in the department of urology at the David Geffen School of Medicine at UCLA in Los Angeles.

But because they weren’t diagnosed early, more black men had cancer that had metastasized or had spread, the researchers found.

“The significant differences observed in prostate cancer incidence resulted in a persistent disparity in prostate cancer metastasis among African American veterans, compared with white veterans despite their nearly equal response to treatment,” Garraway said.

As many have acknowledged, equal access to care has the potential to reduce disparities in key outcomes between racial groups, Garraway said. It is well documented that black people in the United States often have less access to health care and may receive a poorer quality of care compared to white Americans. Because the VA system provides equal access to care, the researchers assumed that black men would benefit from a level playing field.

“Being treated within the VA system reduces some of the disparities in outcomes reported in non-VA populations,” Garraway said. “However, the increased incidence of prostate cancer remains a critical barrier to eliminating racial inequalities.”

Black men have a higher risk of prostate cancer than white men, and black men often do less well and are later diagnosed with more advanced cancer, the researchers noted.

Still, their analysis showed that even in the VA system, which is open to all veterans, the differences between black and white males persisted.

Garraway isn’t sure why these inequalities persist in an equal access and treatment system.

“Many factors influence prostate cancer development and response to treatment, including tumor biology, access to care, and quality of care,” she said, adding that “systematic evaluation of these factors is needed” to eliminate these racial disparities in the future. .

The researchers found that when black and white men were screened for prostate cancer, black men had a 29% greater risk of cancer. They were also younger at the time of diagnosis.

But by focusing on more than 92,000 men, the researchers saw that black men who were diagnosed early and treated definitively had the same results as white men.

The report was published online Jan. 18 in the journal JAMA Network Open.

“There is something that makes black men versus white men treated less aggressively,” says cancer expert Dr. Anthony D’Amico, professor of radiotherapy at Harvard Medical School.

If they have other chronic illnesses that make undergoing aggressive cancer treatment a problem, that could explain some of the disparity the researchers found, he said.

Some patients may also choose not to receive treatment because of some of the side effects, said D’Amico, who was not part of the study.

Race may also play a role, he noted. “I hope not,” he said, adding that some doctors shy away from aggressively treating black men.

D’Amico said any man, regardless of race, who has been diagnosed with prostate cancer should talk to his doctor about the best treatment. “They have to say, ‘Doctor, what is the best possible treatment for this cancer so that I have the highest possible chance of recovery, and then tell me the side effects,'” he said.

He also recommends that men get PSA screening to catch cancer early when it is most curable. The PSA (prostate-specific antigen) blood test measures a protein produced by the prostate gland.

“Screening saves lives, there’s no doubt about it,” said D’Amico. “I think PSA screening is a must for any man, especially for high-risk populations, especially African American and Hispanic men.

“I tell people in the high-risk populations, as well as anyone who has a father or brother with the disease, to get a baseline PSA at 35 and then every year from 40,” D’Amico said.

More information

The US National Cancer Institute has more about prostate cancer treatment.

SOURCES: Isla Garraway, MD, PhD, associate professor, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles; Anthony D’Amico, MD, PhD, professor, radiation oncology, Harvard Medical School, Boston; JAMA Network Open, January 18, 2022, Online

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