Health Care Inequalities Discussed at National Conference
WASHINGTON, Sept. 21 – Prostate cancer can strike any man. But black men have more reason to worry.
While one in six men will get prostate cancer, incidence rates are higher for blacks than for whites, according to the American Cancer Society. And blacks also are twice as likely to die of the disease.
The problem was addressed at a conference here this week hosted by the Waltham-based Prostate Health Education Network Inc., which was founded by Thomas A. Farrington of Concord.
Early detection is key, said Farrington, a five-year prostate cancer survivor, on Tuesday at the African American Prostate Cancer Disparity Summit.
The two-day conference – the first of its kind – had the support of prostate cancer survivor Sen. John Kerry and Rep. Gregory Meeks (D-N.Y.). Legislators, medical professionals and health advocates from around the country stressed the importance of preventive prostate cancer screenings for black men.
“When it comes to prostate cancer, too many African-American men are dying in a health care system that fails to respond to their needs,” Kerry said. “The tragedy is that we can do better.”
The causes of the disparities, said Dr. Carmen L. Pisc, an oncologist affiliated with the Merrimack Valley Hospital in Haverhill, are complex, but involve both genetic background and socioeconomic factors, such as inadequate access to health care.
Blacks make up 12 percent of the country’s population, according to 2000 Census data, but account for 24 percent of the nation’s poor, a central issue of health care accessibility. In Essex County, for example, blacks are 3 percent of the population, but 6 percent of the people below the poverty level are black.
Doctors agree, however, that early diagnosis can bridge the racial gap in mortality rates. It’s getting patients in for screening that is difficult.
Cultural issues play a factor, Pisc said. For instance, in his address to the summit Meeks said: “Brothers cringe at the mention of impotence or incontinence. They think it makes them less of a man. So they don’t deal with it.”
Pisc said, “Ideally we need to go out into the community” to answer questions and “go out there to have frank discussions and put the issues out on the table.”
She said she doesn’t turn down opportunities to speak with the community about prostate, breast and skin cancers. With her male patients over 50 years old, she asks a series of questions gauging changes in sexual and urination functions, the “silent symptoms” as she refers to them, and urges primary care physicians she works with to do the same.
In Lawrence, Mayor Michael J. Sullivan formed a health task force in 2002 to address the city’s health issues, including prostate and breast cancer. The task force has worked with Lawrence General Hospital, the Greater Lawrence Family Health Center and the Caritas Holy Family Hospital in Methuen to offer free prostate screenings for uninsured and underinsured men.
“The real way the city can help is to promote people’s health,” Sullivan said.
Sullivan received a letter last year from a woman who had forced her husband to go to a prostate screening clinic set up by the task force. The screening detected cancer and the man was given a 95 percent cure rate, Sullivan said.
“It tells me how important this is. We need to continue the effort,” he said, adding that there are thousands more men out there who are either afraid to get the tests or don’t have the money.
At the Dana-Farber Cancer Institute in Boston, doctors are being trained to address patients’ cultural differences, said Dr. William K. Oh, an oncologist at the hospital and a professor at Harvard Medical School.
“People have to see we are interested in helping them,” he said.
Oh said researchers have been studying prostate cancer in black men for some time and “there is no evidence that properly diagnosed African-American men will have different outcomes than comparable Caucasian males.”
“It is a very important issue,” he said. “But it is not getting as much attention as it should.”
Health officials in Massachusetts formed a statewide Commission to Eliminate Racial and Ethnic Health Disparities at the beginning of the year, with members from public and private health organizations, the state legislature, and area hospitals.
The commission is scheduled to produce a report in November for Gov. Mitt Romney’s office, according to its charter. The report will include recommendations for improving programs and services and will propose statutory and regulatory changes to reduce disparities in health care.
For more information, call toll free 1-800-ACS-2345 or visit www.cancer.org .
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BREAKOUT:
• In 2005, an estimated 232,090 new cases of prostate cancer will be diagnosed in the United States
• An estimated 30,350 men will die of prostate cancer in 2005.
• Blacks have the highest mortality rate of any racial or ethnic group for all cancers combined and for most major cancers.
• Black men are about 20 percent more likely to get cancer and about 40 percent more likely to die of cancer than white men.
• In general, blacks are less likely to be diagnosed with cancer at an early stage, when treatment is recommended and effective, and are more likely to be diagnosed at a later stage of disease when treatment is either not recommended or is less effective.
Source: American Cancer Society
