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WHY THE PROSTATE CANCER DISPARITY? SOME ANSWERS

Dedicated to addressing the issues surrounding this disparity, researchers and physicians took to the podium at the summit to give an in depth look at some key contributing factors. Presenters from several of the nation's top cancer research centers and universities shared scientific data that shed some new light on reasons for the 60% higher incidence rate and 150% higher death rate that African American men suffer.



Mr. Yussif Dokurugu, Coordinator of the Prostate Cancer Research Project at Florida A&M and Isaac J. Powell, MD, Associate Professor of Urology at Wayne State University and the Karmanos Cancer Institute (Detroit, MI) brought to light the fact that the prostate cancer disparity does not only affect black men in the United States but also their brothers in Africa. Each presented data supporting the fact that black males in West Africa are suffering a prostate cancer epidemic as well as those in the United States. This data is contrary to the long held belief that the higher incidence and mortality rates were unique to black men in the United States. Powell also discussed the epigenetic factors, such as diet and environment, which are putting the African American male at risk. Citing the fact, ?Obesity plays a great role. Diets high in fat, red meat and diary products are contributors to this disease. It?s a very complex disease, but can be cured in 95% of men with proper diagnosis and treatment. The death rate in Caucasians is going down 3-4% a year, however it is decreasing at a slower rate for black men. Therefore the disparity is actually widening.?



Matthew Freedman, MD, a researcher with Dana-Farber Cancer Institute (Boston, MA) discussed how DNA plays a role in prostate cancer disparity, taking participants on a walk through the blueprint of cellular construction. ?We are 99.9% identical at the DNA level, it?s that .1% that makes us genetically different,? explains Freedman. The powerful technique used by Freedman and his colleagues to isolate disease-susceptibility genes is called ?admixture mapping?. This research supports the statement that African Americans are predisposed to higher incidence of prostate cancer on a genetic basis.



Timothy D. Gilligan, MD, an oncologist with the Cleveland Clinic Taussing Cancer Center (Cleveland, OH), moved away from the science and biology of cancer and discussed the differences in health care patients receive based on their ethnicity. ?We know we have inequalities in treatment and inequalities in outcomes.? Gilligan recognized that the disparities are life threatening. A study he conducted in New Jersey showed that African American were 50% less likely to get screened than white men and of those diagnosed 26% were treated less aggressively than white men. ?We don?t see a lot of African Americans at our treatment center, which is one of the best in the nation?, Gilligan concluded.



V. Diane Woods, DrPh at the Loma Linda University Center for Health Disparities and Molecular Medicine (Loma Linda, CA) presented studies that proved African American men were being neglected in the healthcare field and not given the same information and education as white men under the same conditions. During one particular study, Woods interviewed two men, one white and one black in the same age range, who were patients of the same doctor. The white man had been offered screening and information for prostate cancer and the black man, who was at a higher risk, had not been offered either one. From the African American men polled in another study, 62% responded that their doctor never even discussed prostate cancer screening. Woods pushed healthcare facilities to adopt a ?prostate cancer policy?, where there would be certain guidelines that a physician adheres to when dealing with high risk patients.



This session was moderated by James L. Mohler, MD, Chair, Department of Urologic Oncology, Roswell Park Cancer Institute, Buffalo, NY.







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