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Update on Health Disparities -
Redefining the concept of race

One of the continuing areas of controversy and concern is that of racial health disparity. Is it genetics, access, or something else.

Much of the prevailing belief centers on access to care, insufficient patient awareness/education, etc.

Dr. Ash Tewari makes a strong case in this video for why we need to begin looking at patient genetics.

You can view the video here!


The term "health disparities" is often applied to certain ethnic and racial social groups, it describes the increased presence and severity of certain diseases, poorer health outcomes, and greater difficulty in obtaining healthcare services for these races and ethnicities. When systemic barriers to good health are avoidable yet still remain, they are often referred to as "health inequities."

On April 9 - 11, 2019 The Prostate Net in partnership with Vall d´Hebron Institute of Oncology in Spain developed a Symposium to Redefine Disparity with scientists and clinicians from the U.S., Europe and Africa to lay a foundation for on-going study of how research on the subject should be done.

The PSA Test and African-American Men

Dr. Rick Kittles cuts through much of the rhetoric surrounding the efficacy of the PSA test for African-American men. Not enough perspective has been given to the genetic differentials of the test and the underlying issues of the test versus treatment.

Black men bear a much greater prostate cancer burden than white men. Between 1997 and 2001, age-adjusted incidence and mortality rates among Black men are, respectively, 62% and 144% higher than among white men. Higher crude incidence rates among Black men between ages 40 and 60 accounts for some of this difference. There is concern that early screening and treatment for Black men may be warranted; but there is disagreement on appropriate screening, especially for Blacks. Thus, prospective assessment of the efficacy of screening to reduce mortality remains necessary.

The issue of the PSA test has been best addressed in suggesting that those men at high risk from prostate cancer will derive the most benefit from the PSA test. A video discussion by Dr. Ian Thompson will highlight the risk factors and how to use the new Prostate Cancer Risk Calculator

Further addressing the issue of the disparity of incidence and mortality related to prostate cancer, is the impact of genetics presented in African-Americans versus Caucasians. Most recently, Dr. Isaac Powell presented evidence from his research to our Symposium audiences. The thrust of his work derives from the actuation of certain parts of AA gene pathways stimulated by conditions of hereditary/familial incidence and other environmental and/or lifestyle factors of co-morbidity. Dr. Powell's presentation can be viewed here, and you can access the audience comments and questions from the Symposium via our Symposium Portal.

Because many Black men delay in getting the tests that can provide an indication of early stage prostate cancer, they will often not be diagnosed until symptoms (urinary problems, blood in urine, pain, etc.) have begun to appear. Even if these symptoms or others are not present, the cancer may have progressed to a somewhat advanced stage - Gleason 7 or higher - which requires an entirely different management approach. Dr. Ronald Morton, in an interview, provides key information on how best to address an advanced stage tumor at first diagnosis.

The issue of racial health disparity has many roots in genetic incidence, access to information and/or resources, etc.; however, there may be other elements based on cultural factors, socio-economic status, personal responsibility that could be driving the lack of African-American participation in the change necessary to reverse this clinical imbalance. A recent Symposium presentation by Dr. Jean Bonhomme speaks in depth to some of these other barrier issues.

In many cases you will want to reach out for a personal contact to aid in your information search. The Prostate Net® provides a team of survivor counselors who can provide help in your decision-making; you can request their assistance by:


This page is partially supported by an unrestricted educational grant from Augmenix, Inc.and Genentech, Inc.

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Dr. Nihal Mohamed talks about active surveillance research and treatment in high risk prostate cancer patients

Is prostate cancer among African-American men different from other patient groups. Dr. Asutosh Tewari discusses many of the issues surrounding the situation.

Public Service Announcement
Dr. Alan T. Simpson, JR.

Jerry Jackson provides a rationale for all men to become more aware of, and responsible for, their health in order to insure the best possible quality of life.

National Medical Association Physician Locator Service
Designed to increase access to medical care for the underserved

Black Doctor.Org
A comprehensive discussion of conditions relating to the prostate important for all men, but with particular emphasis for African-American men who have the highest rates for prostate cancer incidence and mortality.

African-American Health Center
Information that addresses the full spectrum of health disparities

Being Sure you have the Best Doctor

Centers for Medicare and Medicaid Services
Comprehensive site that details where to find participating doctors, service providers, enrolling in the program, comparing prescription prices, etc.

Federally Qualified Health Centers
Federally-funded health centers provide comprehensive care based on your income and ability to pay even if you have no insurance

National Association of Community Health Centers
Supporting data center for FQHC's and detail on health serving to underserved populations

Crowns Project
An initiative that enables African-American women in churches to help generate awareness of the risks from prostate cancer faced by the men in their lives and communities

Thapelo Institute
A Chicago-based organization focused on improving African-American Men's Health

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