Prostate cancer screening linked to physician-patient relationship

The better the relationship is between men and their health care provider, the greater their chance of receiving prostate cancer screening and the less likely they are to be diagnosed with advanced prostate cancer, regardless of their race, researchers from the University of North Carolina, Chapel Hill, and Roswell Park Cancer Institute, Buffalo, NY, reported in Cancer online.

Their study evaluated experiences of 1,031 African-American and Caucasian men age 50 years and older in North Carolina who had recently been diagnosed with prostate cancer. The objective was to determine the reason for higher incidence and mortality rates from the disease in African-American men compared with Caucasians.

"We found that Caucasian men tended to be seen regularly by the same physician, which appears to be associated with greater trust in their doctors and in physicians in general," said lead author William R. Carpenter, PhD. "They were also more likely than their African-American counterparts to get regular prostate cancer screenings and to get all their medical care at a physician’s office."

The stage of prostate cancer at diagnosis was similar between races in the study; however, mean Gleason scores were higher for African-Americans. African-American men who did not have a prior screening history had a greater chance of being diagnosed with advanced disease and/or more aggressive forms of prostate cancer. However, when men of both races maintained relationships with health care providers, any variation in prostate cancer stage at diagnosis was eliminated.

"These findings suggest that differences in screening result from inconsistent or poorer quality interaction between an African-American man and the American health care system. Improving the interaction between all men, and especially African-American men, and their primary caregivers should reduce prostate cancer deaths in all men and decrease the racial disparity in prostate deaths in African-American men," commented principal investigator James Mohler, MD, of Roswell Park.