More data needed on prostate cancer and men from specific ethnic groups

A review article on issues affecting perceptions of prostate cancer among Black men of African, Afro-Caribbean, and African American ethnicity has highlit the very limited data available about prostate cancer, its diagnosis, and its management in males from specific ethnic groups inside and outside the USA.

Pedersen et al., writing in the journal Psychooncology, were able to identify 13 qualitative studies and data from 20 cross-sectional surveys in the primary literature that addressed the knowledge and perceptions about prostate cancer among Black males. Only two of these studies reported data from outside the USA.

Most of the conclusions they reach are well known here in the USA:

  • Prostate cancer is common and affects men of African, Afro-Caribbean and African American ethnicity more than White men.
  • Awareness of prostate cancer has historically been low among these ethnic groups (although it has risen significantly among African Americans in recent years).
  • Misunderstandings regarding methods of diagnosis and treatment have been and are still widespread.
  • Testing and treatment for prostate cancer is still widely perceived as a threat to Black men’s sense of masculinity.
  • Black males often mistrust the health-care system, have limited access to health care, and do not have trust-based relationships with health professionals.

All of these factors inevitably have impact on Black men’s awareness of and and perceptions about prostate cancer risk, diagnosis, and treatment. They are liable to contribute to the likelihood of delayed diagnosis, and they need to be taken into account when communicating with Black men seeking prostate care.

Over the past decade, here in the USA, we have been able to make considerable progress in the education of Black males about their elevated risk for prostate cancer compared to White and Hispanic males. However, the degree to which similar progress has been made among native Americans and among specific ethnic groups outside the USA is less apparent.

As just one example, a quick search for data on prostate cancer among the indigenous Australian population provided minimal information (see Stumpers and Thompson) and the following statement:

The reported incidence of prostate cancer varies greatly according to the availability and uptake of screening services as well as being influenced by prostate specific antigen (PSA) testing which may be less common in Indigenous Australians …. Given the great differentials in uptake of cancer screening, significance of the differences between Indigenous and non-Indigenous people is not clear. National data on treatment patterns for prostate cancer are also limited although some data exist for [Western Australia].

This despite the fact that prostate cancer is the second most common form of cancer diagnosed among indigenous male Australians (after lung cancer).

Similarly, with respect to American Indian and Alaska Native (AI/AN) males, Henderson et al., in 2008, wrote that,

To the authors’ knowledge, little is known concerning prostate-specific antigen (PSA) testing in AI/AN men.

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