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Author: James Culp
A recent study has revealed a racial disparity in prostate cancer treatment of patients in the U.S.
The study, conducted in 2007 and reported in the Journal of Urology earlier this year, was led by Dr. Kathryn E. Richert-Boe, of Kaiser Permanente Northwest in Portland, Oregon. It's objectives were to determine whether differences existed in prostate cancer treatment received by white and African American men at a health maintenance organization where access to medical care (was) theoretically equal for all members and, if so, to determine the reasons for these differences. The study found that African American patients in the early stages of prostate cancer were less likely than white patients to receive aggressive treatment for their disease.
Researchers conducting the study compared the likelihood of treatment with curative intent (TCI) between the two races, adjusting for age, tumor grade, stage, and the presence of comorbid conditions. What the study revealed was that 82 percent of 158 white prostate cancer patients underwent surgical removal of the prostate gland or radiation therapy for their illness; these are considered more aggressive treatments for the disease. Conversely, only 71 percent of 79 African-American patients received the same type of treatment. Dr. Richert-Boe and the team of researchers investigated whether other factors such as tumor grade, age, overall patient health, and even insurance coverage might explain the difference in treatment; they did not.
Prostate cancer is a leading cancer among men in the United States. In the year 2004, over 189,000 men were diagnosed with the disease. When found early, either through a DRE exam or PSA blood test, treatment is often successful. However, if the cancer goes undetected and reaches advanced stages before it is discovered, effective treatment can be much more difficult.
Prostate cancer in the early stages is often not treated aggressively, because the disease is slow-growing. Many doctors choose to monitor tumor growth and development rather than to prescribe more drastic or aggressive measures early on. The study found that while African American men were just as likely to agree to more aggressive treatments such as surgery or radiation therapy, they were only offered those options in 85 percent of the cases, versus 91 percent for white men.
In the end, the study concluded African American men were less likely to receive TCI than white men. Reasons for the findings in the study are not immediately clear. Additional studies including a larger patient sample is thought to be needed at this point to reveal the true nature of racial disparities in prostate cancer treatment.
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