Prostate cancer screening in African American and Caribbean males: detriment in delay

Prostate cancer, is the greatest in quantity frequently diagnosed cancer in the United States, accounting for 33% of all cancer re cases among men (American Cancer Society, 2004) and is the next to the first leading cause of cancer death in men in the U (American Cancer Society, 2004) In comparison with Caucasian males, African American men are diagnosed with prostate cancer abundant later, and the mortality rate is 24 times higher among African Americans than Caucasians (American Cancer Society, 2004) The age-adjusted incidence of prostate cancer is 225/100000 among African Americans compared with 149/100000 among White, non-Hispanics (Ries, Eisner, Kosary, Hankey, Miller, Clegg et al., 2000) In Florida, the American Cancer Society estimates that 17090 fresh cases of prostate cancer will be diagnosed in 2004 and that 2220 will die of the disease (American Cancer Society, 2003) This difference in diagnosis and mortality is likely owed to African American men delaying or avoiding screening and health disparities in access to care (Seller & Ros 2003)

In addition to the high rates of prostate cancer among African American men in the U other men of the African diaspora have prevalence rates significantly higher than that fix among Caucasian men in the U In a close attention among predominantly African-descended men in Tobago, the screening-detected prevalence rates was 151 of 100 compared with a primarily Caucasian U sample of 38 of 100 (Bunker Patrick, Konety Dhir, Brufsky Vivas et al., 2002) allowing the authors note that procedural differences, eg increased biopsy rates, may partially explain the difference. The authors also compared their ensues with the findings of a U investigation among African Americans and indicate that the Tobago rate may be twice that of the African American rate. In another close attention age-adjusted incidence in Kingston, Jamaica was calculated at 304/ 100000 (Glover Coffey Douglas, Cadogan et al., 1998) These rates were set to be higher than among African American men during a similar time period and with greater morbidity. Later diagnosis of prostate cancer in Jamaica may partially explain these elevated rates among the Jamaican sample (Coard, 2002) Although plenteous research to date points to differences between Caribbean and American men of African fall one study found that serum horizontals of PSA were similar among U.S.--born and Jamaican-born Black men (Chen, MacChia, Conway, Magai, Desai, & Neugut 2004)

bin and others (2002) suggest that African falled men share common genetic or familial factors that may increase vulnerability to prostate cancer. For example, studies of family history in Jamaica display that a man with an affected first stage relative is twice as likely to disentangle prostate cancer (Glover et al., 1998) However, within the diaspora, there is wide variation, suggesting the importance of environmental and lifestyle factors (Brawley, Knopf, & Thompson 1998) Researchers have hypothesized that other risk factors may include age, and a high-fat or meat diet (Ros & Schottenfeld 1996)

In addition to environmental and genetic factors, studies advise that disparities in healthcare access and care may account for a certain number of of the variability in results For example, research has lay the foundation of that Hispanic and African American men received les medical monitoring and had a longer time from diagnosis to medical visits than Caucasian men (Shavers, Brown Klabunde, et al., 2004) and were also more likely to receive watchful waiting as oppos to a more proactive treatment protocol (Shavers, Brown Potosky et al., 2004) Reddy Shapiro, Morton, and Brawley (2003) in summarizing a certain number of of the literature report that differences in patterns of care by the agency of race may contribute to the findings of racial disparity in survival after diagnosis of prostate cancer. Where disparities in access and care are minimized, for example in the military, research place that African American men in the military exhibited reduc risk for prostate cancer compared to non-military African American men (Sanderson, Coker Logan, Zheng, & Fadden, 2004)

BARRIERS TO ACCESS AND CARE

Many studies have examined the barriers to access and care among ethnic minority patients in the U Important factors include structural barriers and those related to education and resources, fears related to treatment results and lack of cultural sensitivity upon the part of healthcare professionals when approaching these issues with minorities. Plowden (1999) assessed five variables in prostate cancer screening in African American men--perceived susceptibility, perceived severity, perceived benefits, perceived barriers and catchwords to action--and found that men will look for screening if these five variables are addressed by the agency of healthcare professionals. Shelton, Weinrich, and Reynolds (1999) rest that the five most public barriers to prostate screening among African American men were lack of knowledge about the ne for screening, lack of finances, lack of insurance, not knowing which physician to diocese for screening, and lack of information about the availability of independent screening. And Watts (1994) lay the foundation of that African American men delayed or avoided screening because of awaited discomfort and a lack of knowledge about the benefits of in every one's mouth therapeutic modalities.