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.
BY BECKY HAM, SCIENCE WRITER
HEALTH BEHAVIOR NEWS SERVICE
The study was supported by the Robert Wood Johnson Foundation and the Department of Veterans Affairs.
FOR MORE INFORMATION
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Vincent Freeman at (708) 202-2414 or freeman@research.hines.med.va.gov.
American Journal of Public Health: (202) 777-2511 or www.ajph.org.
Journal
American Journal of Public Health