Statistics show that African American men are at greater risk of dying from prostate cancer than white men and the majority of statisticians agree that the risk in the case of black men is approximately two and a half times that of white men. But, are these statistics misleading?
The answer might come from a study conducted not long ago in North Carolina. The study involved some 253 white men and 84 black men between the ages of 40 and 75 who were diagnosed with prostate cancer between 2001 and 2004.
The study examined a number of factors including employment, screening history, access to care, symptoms, the existence of other medical conditions, attitudes towards health care and health care providers, family history, treatment, income and whether or not the men had health insurance.
The study discovered that 55 percent of the black men earned under $40,000 annually in comparison to to 23 percent for white men. The study also showed that black men were more likely to be educated to a lower standard, to have a blue-collar job, to have co-existing medical problems and to be unemployed as a result of illness or disability.
In addition the study showed that just 3 percent of white men did not have medical insurance, in comparison to 8 percent of black men and that just over 30 percent of white men has some type of supplemental Medicare coverage, in comparison to 17 percent of black men.
One especially interesting finding was the fact that both groups were well informed about the risks of prostrate cancer and the requirement for treatment, although the black men accepted greater responsibility for their own health and were less likely to trust their doctors. In fact many of the black men said that they were mistrustful of their doctors and felt that any advice given was more likely to be influenced by the cost of treatment than patient needs.
On the important question of screening, black men were less likely 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 black men were more than twice as likely to have to request a PSA test than white men.
The study makes it clear that there is a marked different between the two groups which lies in the lack of early detection in black men and that this arises to a large degree from the fact that they do not have established relationships with their doctors, have poor access to affordable and convenient care and do not carry adequate health insurance.
Obviously it is not easy to assign numbers to a study of this nature and further, and bigger, studies need to be conducted to quantify the differences between black men and white men. Nevertheless, it would seem that much of the difference does not stem from the fact that black men are more likely to develop prostate cancer but lies in the fact that they are more likely to die as a result of the disease because of its late detection.
If the gap between black men and white men in terms of the provision of healthcare were closed the figures could well look quite different.
By Donald Saunders
ProstateProblemCenter.com provides information on many aspects of prostate cancer including prostate cancer treatment and the therapeutic use of prostate milking
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