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

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

A survey of nearly 8 million men seen in American Veterans (VA) hospitals found that black veterans had nearly twice the incidence of localized and advanced prostate cancer than white men.

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

“It is important that African-American men who received final primary treatment had a lower risk of [cancer spreading]”Said study co-author Dr. Isla Garaway, an associate professor in the Department of Urology at David Geffen School of Medicine at UCLA in Los Angeles.

But because they were not diagnosed early, more black men had metastatic cancer or cancer that had spread, the researchers found.

“The significant differences in prostate cancer incidence observed have led to persistent discrepancies in prostate cancer metastases in African-American veterans compared to white veterans, despite their almost equal response to treatment,” Garaway said.

As many acknowledge, equal access to care has the potential to reduce disparities in important outcomes between racial groups, Garway said. It is well documented that black people in the United States often have reduced access to health care and may receive lower quality care than white Americans. Because the VA system provides equal access to care, researchers have suggested that black men will benefit from a level playing field.

“Treatment in the VA system reduces some of the differences in outcomes reported in non-VA populations,” Garway said. “However, the increased overall incidence of prostate cancer remains a critical barrier to eliminating racial differences.”

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

Yet their analysis showed that even in the VA system, which is open to all veterans, the differences between black and white men continue.

Garaway is not sure why these differences continue in a system of equal access and treatment.

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

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

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

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

“Something is driving black men against whites to receive less aggressive treatment,” said cancer expert Dr. Anthony D’Amico, a professor of radiation oncology at Harvard Medical School.

If they have other chronic diseases that make aggressive cancer treatment a problem, that may explain some of the discrepancies found by researchers, he said.

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

More information

The National Cancer Institute of the United States has more information on the treatment of prostate cancer.