Prostate Cancer Deaths a Health Disparity for African-American Men

African-Americans in Contra Costa are more likely to die of cancer than the rest of the county as a whole. In particular, prostate cancer deaths are the largest disparity for African-American men, who are nearly three times as likely to die from this type of cancer as other men living in the county as a whole. (See our Community Health Indicators for Selected Cities and Places in Contra Costa available online at Health Data.)

The cancer disparity is probably related to lack of health care or late detection, but there also may be other factors. And unlike other disparities that we are working to address, the solution for prostate cancer isn't as clear.

Breast Cancer Success Story

We've had some successes addressing cancer disparities. For example, our Public Health Division successfully tackled the disparity for early detection of breast cancer among African-American women in the 1980s and 1990s and eliminated that disparity. But unlike breast cancer, more research is needed on prostate cancer to determine what kind of treatment is most effective and whether early screening and detection really saves lives.

What We Can Do

We have been able to improve patient access to urology services in our system in recent years, which helps expedite diagnosis and treatment of prostate cancer. However, the controversy over prostate cancer screening has divided opinions on the best course of action. In the meanwhile, this disparity will have to be among the health inequities that we remain aware of until we can do more.

The American College of Physicians provided a useful summary of discussion points to consider when counseling patients about prostate cancer screening:

Prostate cancer is an important health problem.
The benefi ts of one-time or repeated screening and aggressive treatment of prostate cancer have not yet been proven.
Digital rectal examinations and PSA measurements can have both false-positive and false-negative results.
The probability that further invasive evaluation will be required as a result of testing is relatively high.
Aggressive therapy is necessary to realize any benefi t from the discovery of a tumor.
A small but fi nite risk for early death and a signifi cant risk for chronic illness, particularly with regard to sexual and urinary function, are associated with these treatments.
Early detection may save lives.
Early detection and treatment may avert future cancer-related illness.

To comment on the RHDI page or suggest a topic, contact Kate Fowlie.

Content provided by the Reducing Health Disparities Initiative of Contra Costa Public Health Division.