Overview:
Black men are less likely to get screening, get diagnostic procedures and have health insurance than white men, significant factors in prostate cancer deaths.
by Jennifer Porter Gore
Prostate cancer remains a significant health challenge for men in general, and for Black men in particular. Data show that one in nine men will be diagnosed with prostate cancer during their lifetime, and those men are more than twice as likely to die from the disease than white men.
The disease became headline news in January, when Defense Secretary Lloyd Austin, the top Pentagon official and arguably one of the most powerful Black men in Washington, was secretly treated for prostate cancer, causing an international uproar. The same month, Dexter Scott King, son of legendary civil rights leader Martin Luther King Jr., died after a long fight with the disease. He was just 8 days away from his 63rd birthday.
And in April, when pro football Hall of Famer and accused murderer O.J. Simpson died at 73, it was weeks before the cause of death — prostate cancer — was made known.
While all three Black men lived significantly different lives, and likely had different risk factors, research suggests that racism in healthcare is a significant factor driving Black men’s disproportionately high rates of prostate cancer diagnoses and fatalities.
“There is clear and compelling evidence that racism strongly influences a man’s risk of death after he develops prostate cancer,” according to a recent report published in the Journal of Clinical Oncology. “Black American patients receive poorer care than white patients, and, moreover, mortality differences generally disappear after adjusting for access to care.”
That lackluster care is evident, experts say, in the lack of communication between Black men and their caregivers.
Early Detection Lacking
Prostate cancer is the most common cancer among men in the U.S.; approximately 3 million men each year are diagnosed with the disease. Although treatable with early detection, it’s second only to skin cancer as the cause of most cancer deaths in men. fatalities in men.
However, for Black men, the numbers are even more troubling. According to Zero Prostate Cancer, a Black man is diagnosed with prostate cancer every 13 minutes, and 17 Black men die from the disease every day.
Many research studies echo what Dr. Andrew Vickers and his colleagues bluntly state in their April 2023 report, “Racism Does Not Cause Prostate Cancer, It Causes Prostate Cancer Death.”
“There is direct evidence that Black men do not get standard-of-care diagnostic workup,” and are half as likely to have biopsies, magnetic-resonance imaging and other procedures to detect and identify cancer, according to the study. At the same time, “there is also compelling evidence that lower socioeconomic status in Black men and disparities in treatment are important drivers of observed differences in survival.”
Yet even after adjusting for socioeconomic factors, “Black patients are less likely to receive surgery or radiotherapy,” according to the study. “Moreover, although curative therapy is less common in Black men both among insured and uninsured patients, the difference is greater in the latter.”
That’s due in part to the fact that Black men are 75% less likely to have health insurance than white men, according to the National Institutes of Health. So, Black men are less likely to receive timely and effective treatment compared to white men, which leads to worse outcomes.
Screening Is Key
The good news is prostate cancer screening can be done during medical check-ups with Prostate-Specific Antigen test, which can detect cancer markers in the blood before symptoms are present. However, the PSA screening test isn’t perfect, and can sometimes generate false positives.
The United States Preventive Services Task Force, which helps establish standards for screening tests, recommends people ages 55 to 69 talk extensively with their medical doctor before choosing to be screened for prostate cancer. The task force advises that men over age 70 should not take the PSA test.
Community-based organizations also play a crucial role in raising awareness and promoting early detection among Black men. Organizations like the Black Men’s Health Initiative and the African American Prostate Cancer Coalition are working to educate Black men about the importance of regular screenings and early detection.
Taking the test may have been a lifesaver for Jerry Bembry. He decided to know whether he was vulnerable to the disease in 2011, not long after his brother died from prostate cancer and his brother-in-law was diagnosed. Like other diseases, prostate cancer can be hereditary.
“I had never considered the possibility of prostate cancer affecting me. But after losing my brother and my brother-in-law’s close call, I made the decision to take a PSA blood test,” said Bembry, who told his story on the Zero Prostate Cancer website. “An alarming spike in my PSA levels prompted a follow-up biopsy. My worst fears were confirmed.”
In 2012, Bembry had surgery to remove his prostate and he’s been cancer free since then.
But even if they have health insurance, Black men in all income groups were half as less likely to have had contact with physicians during the prior year, according to NIH.
Despite these challenges, advances in medical research and technology have improved the detection and treatment of prostate cancer, offering hope for better outcomes.
Precision medicine that offers tailored treatment based on the genetic makeup of an individual’s cancer is becoming more available. These include targeted drugs and radiation, as well as robot-assisted surgery.