NEW YORK-Citing the dispro-portionally high incidence and mortality
of prostate cancer among African-American men, Marc B. Garnick,
MD, associate clinical professor of medicine, Harvard Medical
School, singled out this segment of the population as the target
for intensive efforts to raise awareness.
The latest statistics from the American Cancer Society put the
incidence among African-Americans at 61% greater than that of
Caucasian men. The 5-year survival rates are lower, 65% compared
with 78% for Caucasians. At 43.9 deaths per 100,000, mortality
is twice that of Caucasians.
The main reason for lower survival is suspected to be more advanced
disease at diagnosis. Reduced access to health care, for socioeconomic
and possibly cultural reasons, may be responsible. As a result,
African-Americans are less likely to have timely diagnoses and
more likely to receive suboptimal treatment.
Referring to the findings of a recent Louis Harris survey on awareness,
attitudes, and relationships among prostate cancer patients (see
"Study Uncovers Patient/Physician Communications Gaps"),
Dr. Garnick noted that improved communication is particularly
important in African-American communities.
He proposed that patient information materials be written in a
way that is nonexclusionary in terms of race, level of education
and income, and cultural background. He also urged the development
of printed materials specifically addressed to this high-risk
Citing a finding in the Harris survey that African-Americans were
as likely as other patients to have unspoken concerns about their
disease and treatment, Dr. Garnick said it was essential to address
the tendency of African-American men to be less comfortable discussing
personal and sexual issues with a doctor.
Suggestions ranged from efforts on the part of physicians to improve
their communication and listening skills to adopting a team approach,
employing the services of other medical and nonmedical professionals,
and enlisting the aid of wives and other family members.