Are Black Men Really At More Risk From Prostate Cancer Than White Men?

A quick look at any of the literature will tell you that black men are more likely to die from prostate cancer than white men and most statistics agree that the risk for African Americans is about two and a half times that of white Americans. But are these statistics misleading?

It's well known that there are variations in disease rates between different countries and that, for example, America has the highest rate of obesity of any country and Japan the lowest. But this has very little to do with the passport you hold or the color of your skin and a great deal to with your diet. So why is it that African Americans and white Americans differ so widely when it comes to prostate cancer deaths since they are both members of a common society?

Well, the answer might just lie in a study conducted recently involving a mixed race group of 337 men between the ages of 40 and 75 from North Carolina who were diagnosed between 2001 and 2004 with prostate cancer.

The study looked at a variety of factors including family history, screening history, symptoms, treatment, the presence of other medical problems, access to medical care, the men's relationships with their doctors, their attitudes towards health care and health care providers, employment, income and whether or not the men carried health insurance.

The study found that more than half of the black men earned under $40,000 a year compared to less than a quarter of white men who fell into this income group. The study also found that black men were more likely to have blue-collar jobs, to be educated to a lower standard, to have additional medical conditions and to be unemployed as the result of illness or disability.

The study also found that only three percent of white men had no medical insurance, compared to eight percent of black men and that one-third of white men has some form of supplemental Medicare coverage, compared to seventeen percent of black men.

Perhaps most interestingly the study reported that both black men and white men were equally well informed about the risks posed by prostrate cancer and the need for treatment, but the black men demonstrated a greater sense of responsibility for their own health and were less likely to trust their doctors. Indeed many were suspicious of their doctors and felt that their decisions were more likely to be based on the cost of treatment, rather than on the needs of the patient.

On the important question of screening for the early detection of prostate cancer, black men were less likely to have regular check-ups, digital rectal examinations or PSA blood tests.

Putting all of the data together, it became clear that a significant different between the two groups lay in the lack of early detection in the case of black men resulting in no small part from the fact that they did not have as well established relationships with their doctors, had poor access to affordable and convenient care and lacked the necessary medical insurance.

So what does this mean in terms of the statistical difference when it comes to prostate cancer deaths between African Americans and white Americans? Well, although it's difficult to put numbers to this study and further studies would be necessary to be certain, it would appear that much of the difference does not result from the fact that black men are more likely to contract prostate cancer but simply from the fact that they are more likely to die from prostate cancer because of its late detection.

Clearly the answer doesn't lie in the disease itself but in society's provision of healthcare.