Social and clinical factors influencing prostate cancer treatment in African American and White Men

RESEARCH OBJECTIVE: The death rate for Prostate Cancer (PrCA), which is the most commonly diagnosed cancer in African American men, is twice the rate of white men. African American men in South Carolina have the highest age-adjusted death in the nation. Studies have shown that the treatment offered to African American men with PrCA is systematically different from that offered to EA men.

STUDY DESIGN: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. We performed a descriptive assessment of the factors that influenced PrCA treatment decisions.

POPULATION STUDIED: Men diagnosed with PrCA between 1996 and 2002 were eligible to participate.

PRINCIPAL FINDINGS: African American men were more likely to undergo aggressive types compared to their white counterparts. The treatment choices of African American men were significantly more likely to be influenced by pain avoidance and significantly less likely to be influenced by cure potential compared to white men. African American men were also significantly more likely to live without a wife or partner were more likely to live alone, and were significantly more likely to have difficult attending doctor appointments than white men. PSA changes were significantly less likely to occur in African American men than white men.

CONCLUSIONS: African American men were less likely to report cure as an influence of treatment decision and more likely to report pain avoidance as an influence of treatment decisions.

IMPLICATIONS: Despite the national undertaking to eliminate health disparities, the United States is far from a comprehensive focus on the health of African American men, despite the elevated morbidity and mortality they face. This must start at the federal level through policy and programmatic adjustments.