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Minority issues in prostate disease.

Dan B French1, LeRoy A Jones

  • 1Department of Urology, University of Texas Health Science Center at San Antonio, MC 7845, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.

The Medical Clinics of North America
|June 1, 2005
PubMed
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African American men face higher prostate cancer incidence and mortality. Early screening, considering PSA levels and family history, is crucial for this demographic.

Area of Science:

  • Urology
  • Oncology
  • Public Health

Background:

  • African American men exhibit disproportionately higher prostate cancer incidence and mortality rates.
  • Contributing factors may include genetics, healthcare disparities, and comorbidities like diabetes and hypertension.
  • Socioeconomic status and access to healthcare significantly influence prostate cancer outcomes.

Purpose of the Study:

  • To discuss the increased incidence and mortality of prostate cancer in African American men.
  • To explore the role of genetics, healthcare practices, and socioeconomic factors.
  • To provide updated information on prostate cancer screening guidelines and recommendations.

Main Methods:

  • Review of current literature on prostate cancer disparities.

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  • Analysis of prostate cancer screening guidelines from major urological and cancer organizations.
  • Discussion of recent studies questioning the traditional PSA cutoff for screening.

    • Main Results:

    • Prostate cancer screening remains controversial, with differing recommendations from professional societies.
    • Overall prostate cancer mortality appears to have decreased since the advent of screening tools.
    • A significant risk of prostate cancer exists even with PSA levels between 3.1 and 4 ng/mL, particularly for high-grade disease.

    Conclusions:

    • Similar disease stages and equal healthcare access lead to comparable outcomes.
    • Primary care physicians play a vital role in educating and encouraging prostate cancer screening among African American men.
    • Screening should be offered to all men aged 50+, and to African American men or those with a family history starting at age 40, involving both digital rectal examination and PSA testing.