March 12, 2007 -- Decreasing the rates of prostate cancer among black men may require improving access to routine health care, rather than increased education about the disease, a study from the University of North Carolina at Chapel Hill School of Medicine suggests.
African American men have the highest prostate cancer rate in the world.
"African-American men were aware of their increased risk of prostate cancer, and they felt responsible for getting themselves to physicians for preventative care. But there were substantial barriers to their carrying out what they saw as being important," said the study's senior author, Dr. Paul A. Godley, associate professor of hematology and oncology in UNC's School of Medicine and Lineberger Comprehensive Cancer Center.
Black men are more likely than white men to get prostate cancer, and their death rate from the disease is more than two times higher, according to the American Cancer Society. The study is published online March 12, 2007 in Cancer. Dr. James A. Talcott of the Massachusetts General Hospital Cancer Center and Harvard Medical School is the lead author.
In a survey of black and white men in North Carolina who were recently diagnosed with prostate cancer, black men were more than twice as likely than white men to report getting their care at public clinics or emergency rooms, rather than a private physician's office.
"In addition, African-American men were slightly less likely than white men to say they trusted their physicians. As with the other findings, lack of trust seemed to stem from the lack of a regular source of health care" Godley said.
"This wasn't coming from some historical distrust from previous abuses but was coming from people's own experience with the health-care system" Godley said.
"If you don't have a doctor and have to repeat your whole history to an emergency room physician every time you have a medical encounter, then it's harder to develop trust in physicians."
"The reassuring part of the findings is that measures to generally make health care more accessible would also potentially address some of the disparities in prostate cancer," he said.
Godley is also affiliated with UNC's Cecil G. Sheps Center for Health Services Research and School of Public Health.
Other authors of the study from UNC are Dr. Joseph A. Galanko of the School of Medicine; Dr. William R. Carpenter of Lineberger Comprehensive Cancer Center; Dr. Pamela Spain and Anne Jackman, of the Cecil G. Sheps Center for Health Services Research; and Dr. Young Kyung Do of the School of Public Health. Dr. Jack A. Clark of Boston University and Dr. Robert J. Hamilton of the University of Toronto are also authors.
The study was funded by the Agency for Healthcare Research and Quality.
The authors plan to release analysis of additional data from the survey in a separate study.
