Data shows that African American men are more likely to die from prostate cancer than white men and most statisticians are in agreement that the risk in the case of black men is around about two and a half times that of white men. But, are these statistics misleading?
The answer might be found in a study carried out recently in North Carolina. The study involved some 253 white men and 84 African Americans between the ages of 40 and 75 who were diagnosed with prostate cancer between 2001 and 2004.
The study examined several factors including screening history, the existence of other medical conditions, symptoms, access to care, employment, treatment, attitudes towards health care and health care providers, family history, income and whether or not the men had health insurance.
The study found that 55 percent of the African Americans earned less than $40,000 annually compared to 23 percent for the white men. It also showed that African Americans were more likely to be less well educated, to have a blue-collar job, to have other accompanying medical problems and to be unemployed as a result of disability or illness.
The study further showed that just 3 percent of white men had no medical insurance at all, compared to 8 percent of African Americans and that just over 30 percent of white men has some type of supplemental Medicare coverage, compared to 17 percent of African Americans.
One particularly interesting finding from the study was the fact that both groups of men were equally well informed about both the risks of prostrate cancer and the need for treatment, but that the African Americans accepted more responsibility for their own health and were less likely to trust their doctors. In fact several of the African Americans said they were suspicious of their doctors and felt that any advice given was more likely to be based on the cost of treatment than patient needs.
When it came to screening, African Americans were less inclined to have regular check-ups, digital rectal examinations or prostate specific antigen (PSA) tests. It was also interesting to note that the study reported that African Americans were more than twice as likely to have to ask for a PSA test than white men.
It is clear from this study that there is a marked different between the two groups that lies in the lack of early detection in the case of African Americans and that this arises to a significant degree from the fact that they do not have well established relationships with their physicians, have poor access to affordable and convenient care and do not carry adequate health insurance.
Obviously it is not easy to put numbers to a study of this nature and additional, and bigger, studies must to be carried out to quantify the differences between black men and white men. Nonetheless, it appears that much of the difference does not lie in the fact that black men are more likely to develop prostate cancer but stems from the fact that they are more likely to die as a result of the disease because of its was detected late.
If the gap between black men and white men as far as the provision of healthcare were narrowed the statistics might well look quite different.
