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Equal Access Erases Racial Disparity in Prostate Cancer Stage

Equal Access Erases Racial Disparity in Prostate Cancer Stage

WASHINGTON—Black men historically have some of the world’s worst
rates of prostate cancer incidence and mortality, with prognostic features
significantly worse than those of white Americans.

But the longstanding staging disparity "evaporated" among men
undergoing radical prostatectomy when members of both races had equal
medical care, including equal access to PSA screening, reported Colonel Judd
W. Moul, MD, of the US Army Medical Corps and director of the Department of
Defense Center for Prostate Disease Research at the Uniformed Services
University of the Health Sciences, Bethesda, Maryland.

Speaking at the 8th Biennial Symposium on Minorities, the Medically
Underserved,
and Cancer, Dr. Moul described a study of the impact of PSA screening among
2,042 black and white military service members diagnosed with prostate
cancer.

Health care in the armed services, he emphasized, has completely open
access and is equal for all members. The military population is relatively
well educated and receives regular health information. This combination of
circumstances "wiped out the pathological disparity" between the
races, he said (see Figure 1).

Historically, he said, there has been a "huge difference" in
positive margins between black and white prostate patients who undergo
radical prostatectomy.

The study examined data on prostatectomy patients between 1988 and 1999.
Over that period, the improvement in pretreatment PSA levels was
"dramatic" for both races, with cancers being caught earlier in
the disease course and among men of younger ages. The lowering of age at
diagnosis, he indicated, is a "first sign" of a successful
screening technique.

Overall survival, including disease-specific survival, also improved over
the period (see Figure 2).

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