Prostate Cancer Screening And Trust Of Physician Evaluated

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health
Article Date: 30 Jul 2009 - 2:00 PDT

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Trusted health care sources and continuity of care may help reduce the risk of prostate cancer deaths in African-American men, according to a study published in the current issue of the journal Cancer. James Mohler, MD, Chair of the Department of Urology at Roswell Park Cancer Institute (RPCI), and William R. Carpenter, PhD, Department of Health Policy and Management at the University of North Carolina, are lead investigators.

The research analyzed physician trust, continuity of health care, the regular source of health care and their effects on prostate cancer early detection among newly-diagnosed prostate cancer patients from North Carolina and Louisiana.

The study enrolled 1,031 African-American and Caucasian-American men, age 50 and over, within weeks of their diagnosis of prostate cancer. A study nurse conducted a structured survey and acquired biological specimens in a home visit and abstracted medical information directly from medical records.

In this study, the stage of prostate cancer at diagnosis was similar between races, but the mean Gleason scores, an indication of the aggressiveness of the disease, were higher for African-Americans than Caucasian-Americans. African-Americans were less likely than Caucasians to report participation in prostate cancer screening prior to diagnosis. Men without a prior history of screening were more likely to be diagnosed with advanced disease and/or more aggressive forms of prostate cancer. However, when men of either race had established relationships with the same health care provider, these differences in prostate cancer aggressiveness went away. Therefore, addressing racial differences in use of screening may reduce racial disparities in prostate cancer diagnosis and treatment, and, by extension, may reduce disparities in prostate cancer deaths.

"The goal of the study was to gain a deeper understanding of the role of racial disparities in prostate cancer outcomes," said Dr. Mohler. "These findings suggest that differences in screening result from inconsistent or poorer quality interaction between an African-American man and the American health care system. If the interaction is poor, the care giver may not get around to discussing or offering preventive health care, such as prostate cancer screening. Improving the interaction between all men, and especially African-American men, and their primary care givers should reduce prostate cancer deaths in all men and decrease the racial disparity in prostate deaths in African-American men."

Dr. Carpenter added, "Factors in health care systems, including setting and continuity of care, may hinder the development of physician-patient relationships. These factors may preclude or limit discussions about preventive health care and early detection of disease through prostate cancer screening."

The mission of Roswell Park Cancer Institute (RPCI) is to understand, prevent and cure cancer. RPCI, founded in 1898, was one of the first cancer centers in the country to be named a National Cancer Institute-designated comprehensive cancer center and remains the only facility with this designation in Upstate New York. The Institute is a member of the prestigious National Comprehensive Cancer Network, an alliance of the nation's leading cancer centers; maintains affiliate sites; and is a partner in national and international collaborative programs.

Source: Roswell Park Cancer Institute