Prostate cancer is the most common cancer affecting American men.
In 2010, an estimated 217,730 men were diagnosed with it and 32,050 died of it, according to a report in the Cleveland Clinic Journal of Medicine by Dr. Charles Modlin, a urologist and kidney transplant surgeon and director of the Minority Men’s Health Center at the Cleveland Clinic in Ohio.
Modlin noted that black African American men had a prostate cancer incidence two-thirds higher than whites and a mortality rate twice as high.
Modlin is also a national leader and spokesman for the elimination of health disparities and during September, National Prostate Cancer Awareness Month, he is focusing on bringing greater awareness of the disproportionate rates of the disease and to encourage black men to take better care of their health.
“After I finished my formal medical education, I was able to step back and take a broader view of the medical landscape. That’s when I really became aware of the healthcare disparity crisis. It’s also when I started thinking about what we can do at the Cleveland Clinic, as an organization, to have a positive impact on reducing healthcare disparities,” Modlin told Profiles in Diversity Journal in an interview published in May.
While poverty and lack of access to good health care can impact outcomes for African Americans, Modlin said it’s not the only contributing factor.
“I think one of the most obvious causes is lack of access to quality healthcare, often due to impoverishment,” Modlin told the journal. “But it goes beyond lack of access. There are a number of patients who actually have access to health insurance, but choose not to [use them] because they don’t think it’s important or out of fear. I think there are patient and healthcare system factors, too. There are unhealthy behaviors, but there are also biological causes that play in, and these can all be combined with environmental factors as well.”
In the Cleveland Clinic journal, Modlin wrote that PSA cutoff levels had not been modified by race (although there are indications of disproportional impact for black men). The studies suggested there was little difference in detecting cancer – or the stage at which it was found – through earlier PSA testing.
Some of that data did not include a significant population of African American men in the studies, however, and some researchers say the recommendation from those studies does not serve black men well at all.
But black men tend to have higher PSA levels with or without cancer, according to Modlin, so regular screenings are likely more critical.
“…we believe primary care physicians should have a lower threshold for referring African American men who have a suspiciously high PSA level for further urologic evaluation,” Modlin said.
He also noted that men also can benefit from a healthy lifestyle, including daily exercise, maintaining a healthy body weight and eating a low-fat diet.
But they should get tested, know their family history and stay on top of their health profile.