The answer to this question may be found in a study carried out not long ago in North Carolina. The study involved some 253 white men and 84 African Americans aged between 40 and 75 who had been diagnosed with prostate cancer between 2001 and 2004.



The study considered several factors including, income, attitudes towards health care and health care providers, access to care, employment, family history, screening history, the existence of other medical conditions, treatment, symptoms and whether the men had health insurance.

The study discovered that 55 percent of the African Americans earned under $40,000 a year compared to 23 percent for white men. The study also showed that African Americans were more likely to be less well educated, to have blue-collar jobs, to have co-existing medical problems and to be unemployed because of illness or disability.

Additionally, the study showed that only 3 percent of white men did not have medical insurance, compared to 8 percent of African Americans and that just over 30 percent of white men has some type of supplemental Medicare coverage, compared to 17 percent of African Americans.

One particularly interesting finding was the fact that both groups of men were well informed about both the risks of prostrate cancer and the need for treatment, but that the African Americans took greater responsibility for their own health and were not as likely to trust their doctors. In fact several of the African Americans stated that they were mistrustful of their doctors and believed that the advice they were giving was more likely to be influenced by the cost of treatment than it was to be based upon patient needs.

On the important question of screening, African Americans were less inclined to have regular check-ups, digital rectal examinations or prostate specific antigen (PSA) tests. The study also reported that African Americans were more than twice as likely to have had to request a PSA test than white men.

The study makes it clear that there is a marked different between the two groups which lies in the lack of early detection in the case of African Americans and that this arises to a large degree from the fact that they do not have sound relationships with their doctors, have poor access to affordable and convenient care and do not carry adequate health insurance.

Clearly it is difficult to assign numbers to a study of this type and further, and larger, studies will have to be carried out to quantify the differenced between African Americans and white Americans. Nevertheless, it would appear that much of the difference does not lie in the fact that African Americans are more likely to develop prostate cancer but stems from the fact that they are more likely to die from the disease because of its late detection.

If the gap between the two groups as far as the provision of healthcare were narrowed the statistics could well look very different.