African-American men significantly underestimate their risk of a positive prostate biopsy


According to new data from a study at the University of Chicago, African-American males scheduled for a prostate biopsy are at greater risk for a positive diagnosis of cancer than white males and they also significantly underestimate their probability of a positive biopsy result.

The new study by Hemmerich et al. was based on data from African-American and white males who were surveyed immediately prior to the conduict of a prostate biopsy. The survey tool was carefully designed to assess such things as the patients’ estimates of actually having prostate cancer, their socio-demographic status, their general health, their clinical status, their general level of anziety, and their prostate cancer-specific anxiety.

Here are the major results presented by the authors:

  • The study enrolled 478 men (207 African Americans and 271 whites).
  • 106/207 African Americans (51 percent) stated that they had no likelihood of a diagnosis of prostate cancer at all.
  • Only 52/271 whites (19 percent) stated that they had no likelihood of a diagnosis of prostate cancer at all.
  • 118/207 African Americans (57 percent) had abnormal biopsy results.
  • 114/271 whites (42 percent) had abnormal biopsy results.
  • The following criteria were significant predictors of patients’ beliefs that thay had zero likelihood of a diagnosis of prostate cancer
    • African-American ethnicity (OR = 4.50; p < 0.001)
    • Lower levels of prostate cancer-specific anxiety (OR = 0.93; p < 0.01)
    • Less education (OR = 2.38; p < 0.05)
    • Less urinary disturbance (OR = 0.70; p < 0.05).

It is not yet clear why African-American men scheduled for a biopsy would have such significantly lower estimates for their risk of a positive biopsy result, but it does make one wonder just how many African Americans do not even go for a recommended biopsy, thus increasing their risk for a delay in diagnosis until their cancer has progressed to become incurable.

These data also imply that the nature of conversations about testing for risk of prostate cancer between African-American males and their doctors may need to be significantly differently framed than the conversations between white men and their physicians.

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