Early detection issues of prostate cancer in African American men

There were 35,000 deaths from prostate cancer estimated in 1993. The mortality rate among African American men from prostate cancer is 2-3 times higher than among Caucasian Men between the ages of 50-70. There may be many reason for this disproportionate mortality such as a genetic basis, diet or a difference in doubling time between the ethnic groups. Differences in access to care has also been suggested as a cause for this difference. But what has been clearly demonstrated is that African Americans are diagnosed with prostate cancer at a more advanced stage. Thus, health seeking barriers that delay the diagnosis of prostate cancer until cure or long-term quality survival is no longer possible, may be a primary reason for this disproportionate mortality. Since a higher percentage of African Americans present with advanced and remote prostate cancer, it seems reasonable to focus our attention on programs directed towards early detection of prostate cancer in this high risk population. However there are several controversies associated with early detection such as its benefit, over-treatment, and cost. Perhaps the investigation and resolution of these issues should begin in a high risk population.