February is Black History Month, a time to recognize the many important contributions African Americans have made to society and highlight important issues in the Black community. One way to do this is by prioritizing health equity among Black men.
Did you know prostate cancer is the second most common type of cancer in men and the second leading cause of cancer deaths among men? About one in eight men will be diagnosed with the disease in his lifetime.
But Black men in particular are at increased risk of prostate cancer, with one in six getting the disease in his lifetime. Black men are also twice as likely as white men to die from the disease. In fact, prostate cancer is more common among Black men than any other racial or ethnic group.
Why the racial disparities?
Exactly why these health disparities exist is not well understood. Scientists believe it could be down to certain biological differences, or that traditional biopsies — procedures to extract samples of tissue to look for diseases — may miss areas of high-grade prostate cancer in Black men, leading to more misdiagnosis. Genetic factors such as a family history may also put Black men at higher risk.
Some other factors linked with the legacy of racial discrimination likely play a role, including:
- Lack of access to healthcare
- Quality of care
- Greater mistrust of the healthcare system due to historic precedent
- Social determinants of health, such as poverty and poor diet
- Higher risk of multiple chronic conditions like heart disease, diabetes and obesity, which can increase cancer risk independently or via shared risk factors — and reduce the likelihood of survival
Fortunately, significant progress is already occurring to reduce these disparities and there are more steps the healthcare community and patients can take to produce equitable outcomes.
Cancer research and clinical trials
To address these disparities, healthcare providers need evidence and insights representing all patients. Clinicians make important decisions based on data from clinical research. However, many clinical trials enroll patient groups that are not representative of the general population. As a result, we might be missing out on important insights that can serve historically underrepresented groups, such as Black men.
Clinicians are calling for the inclusion of more underrepresented minorities in prostate cancer research and the need to conduct more genomic analysis of populations with African ancestry. One organization called ConDUC is working to build a registry of Black men diagnosed with prostate cancer to better understand the natural history, treatment regimens, and positive outcomes, and get more Black men with the disease into clinical trials.
Patients and PSA testing
Getting screened regularly is key to early detection. The five-year relative survival rate for Black men diagnosed with prostate cancer at any stage is 97% when the disease is caught early, according to Zero, a nonprofit focused on ending the disease. Yet only one-third of eligible Black men participate in prostate cancer screenings, according to the American Cancer Society.
Black men can undergo proactive prostate cancer screening by getting a prostate-specific antigen (PSA) blood test.
The American Cancer Society recommends that men at high risk, including Black men and those who have a son, brother or father with the disease, get screened starting at age 45. The American Urological Association recommends screening starting at age 40.
Speak with your doctor about your concerns, specific health risks and whether you should get a PSA screening. Check out these tips on discussing prostate cancer with your doctor or other provider from the American Cancer Society.
By promoting more awareness of prostate cancer and its risk factors, we can narrow racial disparities and save lives.