Black men have historically faced worse outcomes from prostate cancer, and this study provides a meta-analysis of past research on this topic in order to discuss ways to move forward.
Prostate cancer is the most common type of cancer diagnosed in men in the United States. Although there have been advancements made in the screening and treatment of prostate cancer, racial disparities have persisted for a number of races and ethnicities, in particular for Black men as regards both survival rate and the quality of care. This disparity is well established and has been documented and reported since 1993. A recent study, published in Current Oncology Reports, provides a meta-analysis of past publications analyzing this subject.
Black Men Show Worse Prostate Cancer Outcomes
Research dating back to 1993 showed that at diagnosis, 26% of White men presented with stage 4 prostate cancer, compared to 52% of Black men. This disparity resulted in a decreased survival rate for Black men, although it did not persist when controlling for cancer stage. Researchers at the time hypothesized that it was the result of decreased access to medical care among Black men, although the type of medical care was the same for both Black and White cohorts in this study. Instead, social determinants of health, such as transportation access, medical care usage rates resulting from insurance, and other factors were seen as the most likely culprits.
Disparities exist both at the level of diagnosis and treatment as well as in screening. One study found that as distance from a urologist increased, so did delayed diagnosis of prostate cancer in both Black and White men. However, this disparity was more pronounced for Black men. Another study found that Black men under 65 years of age had 45% lower odds of undergoing a prostate biopsy when compared to White men.
Clinical Trials for Prostate Cancer Enroll Black Men at Low Rates
Disparities also persist when it comes to clinical trials. One study found that in various cancer trials, only 49.7% reported on race and ethnicity at all. Black and Asian patients were found to be poorly represented across cancer types, with only 2.9% of participants reporting their ethnicity as Black. Because Black men are at a particular risk of prostate cancer, there is an increased need for them to be represented in trials.
Increasing Screenings and Access to Care is the Path Forward
Although these disparities still persist, progress has been made, with overall cancer mortality disparities narrowing. The data also indicates a clear path forward, supporting the idea that improvements in screening, care delivery and access, and trial enrollment can lead to significant improvements for all prostate cancer patients, regardless of race.
Fu, J., Fu, C., Wang, R. S., Geynisman, D. M., Ghatalia, P., Lynch, S. M., Harrison, S. R., Tagai, E. K., & Ragin, C. (2023). Current Status and Future Direction to Address Disparities in Diversity, Equity, and Inclusion in Prostate Cancer Care. Current Oncology Reports, 1-10. https://doi.org/10.1007/s11912-023-01399-0