Men without other diagnosed illnesses may have less contact with health
care professionals in general, increasing the chances that another disease
or condition has gone undiagnosed and that their cancer will be in the
middle or advanced stages of development by the time it is discovered,
researchers suggest.
The study was conducted by Vincent Freeman, M.D., M.P.H., of Midwest Center
for Health Services and Policy Research and appears in the American
Journal of Public Health.
“This association probably reflects the action of cultural and social
forces (rather than a racial effect per se) that led to underdetection
or delayed detection” of the cancer, Freeman says.
The researchers looked for possible links between other illnesses and
prostate cancer to see if they could help explain the gap in black and
white deaths of prostate cancer patients. Black men with prostate cancer
typically have lower overall survival rates than their white counterparts.
Freeman and colleagues combed through the medical records of 864 patients
in the Chicago area who were diagnosed with prostate cancer between 1986
and 1990. By the end of 2001, 507 of the men had died, with 215 men succumbing
to prostate cancer itself and the other 292 dying from other causes.
Black men were significantly more likely than white men to die from both
prostate cancer and other causes during the study. Black men were also
more likely to have other illnesses like diabetes, kidney disease and stroke
at the time of their cancer diagnosis.
The researchers say these extra illnesses, however, are
not to blame for the gap between black and white deaths from prostate
cancer. In fact,
the gap “disappeared” when both white and black men suffered
from equally high levels of other illness.
Instead, black men without any other diagnosed illnesses had the greatest
risk of dying during the study, possibly because they did not receive the
regular or high-quality care that would have uncovered those illnesses.
The study was supported by the Robert Wood Johnson Foundation and the
Department of Veterans Affairs.
