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In light of persistent racial disparities in prostate cancer care, a recent review discusses current understanding and future directions towards a more equitable healthcare approach. Highlighting the importance of social determinants of health, the study points to potential strategies for improving the standard of care for marginalized communities.

  • Disparities in prostate cancer care are well documented, particularly among Black men.
  • Social determinants of health significantly impact racial disparities across the prostate cancer care continuum.
  • Tailored interventions and strategies, such as community-based education and improving access to care, can help close the gap.
  • The integration of social determinants of health data into electronic medical records may help identify and address barriers to care.

According to a study published in the journal Current Oncology Reports, prostate cancer is the most common type of cancer diagnosed in men in the U.S. Despite advancements in screening and treatment, racial disparities persist, especially among Black men. Earlier research revealed Black men have greater risks for many types of cancer, and factors beyond medical care access, such as social determinants of medicine, contribute to these disparities.

Screening Disparities and Responses to Standard Care

Despite advancements in screening technologies, there was a decline in PSA screening rates from 2012 to 2018, especially among non-Hispanic Black men and other marginalized groups. Paradoxically, this trend is observed even as emerging data suggest that screening particularly benefits Black men, necessitating a focus on improving screening rates within these demographics. 

In addition, higher rates of utilization for mpMRI diagnostic imaging were reported for wealthier, privately insured individuals. Importantly, studies reveal differential responses to standard care along racial lines, with Black men receiving androgen deprivation therapy (ADT) less frequently, impacting their survival outcomes. Such findings underscore the need for equity in screening access and tailored care delivery for varied demographic groups.

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Social Determinants of Health and Their Impact

The social determinants of health (SDOH), defined as conditions in the environments where people are born, live, and work, play a significant role in health disparities. Economic stability, education, social and community context, health and healthcare access, and neighborhood and built environment are identified as key SDOH domains. The blurred lines between these determinants often apply to patients in multiple ways, affecting prostate cancer patients at every step of the continuum.

Innovative Approaches and Interventions

Several interventions have shown promise in addressing disparities in prostate cancer care. Community-based programs, such as information and education initiatives for Black men in barbershops have had success in increasing screening rates. Improved access to medical infrastructure consistently translates to better outcomes in vulnerable populations. For instance, Black men in the VA system have similar or even better survival outcomes when compared to their White counterparts once access disparities are eliminated.

Applying Insights to Practice

For healthcare providers, understanding and addressing the social determinants of health is vital for providing equitable care. Incorporating SDOH measures into electronic medical records could help identify and address barriers to care. Though disparities in prostate cancer care still exist, progress is being made, and improvements in screening, access, care delivery, and trial enrollment may translate into meaningful outcome improvements for all prostate cancer patients.

Source:

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, 25(7), 699–708. https://doi.org/10.1007/s11912-023-01399-0