By Walter Stadler, M.D., medical oncologist and Chief Clinical Officer of City of Hope® Cancer Center Chicago, and Scott McLellan, Executive Director of The Julian Grace Foundation.
Prostate cancer disproportionately affects Black men, making it one of the most pressing cancer disparities affecting the Black community. Chicago and other American cities won’t close the survival gap unless Black men have better access to earlier screenings and equitable care.
The impact is especially evident in Cook County, Illinois, where Black men represent approximately 22% of the population, but account for nearly 33% of all prostate cancer diagnoses countywide, according to the Illinois Department of Public Health. Nationwide, the picture is much the same: Black men represent about 5.7% of the population, according to the U.S. Census Bureau, but account for nearly 30% of all prostate cancer deaths, according to the National Institutes of Health.
What’s more, federal statistics indicate 1 in 6 Black men will develop prostate cancer in their lifetimes, compared to 1 in 8 white men, according to the Prostate Cancer Foundation. Black men are also twice as likely to die from prostate cancer than white men.
But it doesn’t have to be this way. In fact, prostate cancer is 99% curable when caught early, through cancer screening, including a simple annual PSA (prostate-specific antigen) blood test. Testing is critical because early prostate cancer usually does not cause symptoms.
To examine what’s behind the racial disparities in prostate cancer, and what can be done to close the gap, this article examines:
- Inequities in prostate cancer
- Expanding access to screening and care
- Closing the gap: What can be done?
- Reducing risks: What steps can men take?
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial consultation or a second opinion, call us 24/7 at 877-460-4673.
Inequities in Prostate Cancer
When we look at the data, there is substantial evidence that outcomes for Black patients with prostate cancer are worse, with mortality rates approximately twice as high as those of non-Black men.
These disparities are often closely tied to a range of socioeconomic factors that may affect when and how people access care. Challenges such as limited access to screenings and healthcare services, transportation barriers, difficulty taking time away from work and gaps in insurance coverage can all delay diagnosis and treatment.
Chronic stress and other conditions that influence overall health may also contribute.
Together, these factors increase the likelihood that prostate cancer is diagnosed later, when it is more difficult to treat.
Expanding Access to Screening and Care
Evidence suggests that when barriers to care are reduced and patients receive more consistent, equitable treatment, disparities in outcomes can narrow significantly.
One study conducted by U.S. Department of Veterans Affairs (VA) researchers showed that Black patients receiving prostate cancer care in the VA system were, on the whole, treated the same way as White patients.
The result is that Black veterans experienced similar outcomes to their white counterparts. There are surely lessons to be learned from the VA’s approach to minimizing health inequities.
Closing the Gap: What Can Be Done?
Addressing inequities in diagnosing and treating prostate cancer comes down to two factors:
- First, we must not ignore the socio-environmental and historical factors that make the most appropriate care they deserve less accessible to Black patients.
- Second, we must ensure our Black men and their families understand the importance of screening for prostate cancer using tools like PSA tests, as well as more advanced methods like genetic testing.
Why are these two factors important? Because early diagnosis and modern care lead to better outcomes.
Addressing these broader inequities will also require sustained efforts from healthcare systems, policymakers and communities alike.
That is why City of Hope, a national leader in prostate cancer treatment and research, and the Julian Grace Foundation, a philanthropic organization dedicated to advancing opportunity, equity and change, have joined forces with other community partners across Northern Illinois to address this important topic.
Our shared goal was and continues to be simple: to ensure that every man in the greater Chicagoland area, and beyond, has the same chance to survive and thrive after a prostate cancer diagnosis.
In August, the two organizations convened a meeting of leading experts to address how prostate cancer continues to disproportionately affect Black communities and promote education on early detection and equitable care.
Additionally, the session covered breakthrough research advancements in prostate cancer care that are changing the trajectory of the disease.
Reducing Risks: What Steps Can Men Take?
While these conversations must continue at the broader level, there are important steps men can take to advocate for their own health and understand their prostate cancer risk factors, including having proactive conversations with a physician.
Every man’s risk profile is different, and factors such as family history, genetics and overall health should help guide decisions about when screening should start and how often it should occur.
By talking openly with a primary care physician or urologist about their personal risks, Black men are able to make informed decisions about PSA testing and other screening approaches that may help detect prostate cancer earlier.
Additionally, it is important to understand the biological factors that may increase a man’s risk. One such factor that markedly increases the risk of prostate cancer is a mutation in the BRCA2 gene. This inherited mutation (meaning that one is born with this alteration) not only increases the risk of developing prostate cancer in biologically males, but also increases the risk of developing ovarian and breast cancer in biological females.
As a result, blood relatives of a prostate cancer patient with such a mutation are also at risk for being a mutation carrier and as such at an increased risk for certain cancer. Notably, BRCA2 gene mutations are more common in Black individuals than other ethnicities.
The good news is that there is a relatively simple blood test that can detect BRCA2 gene mutations. This is a key tool in treating prostate cancer patients, not only because it then becomes important that their sons, brothers, sisters and daughters are tested, but more importantly for the patient, such a mutation predicts marked benefit from specific drugs known as PARP inhibitors.
Prostate cancer disparities are not inevitable. We know that when Black men have access to timely screening, trusted information and high-quality care, outcomes improve. By increasing awareness, reducing barriers to care and helping men understand their individual risks, we can detect more cancers at earlier, more treatable stages and move closer to a future we can ultimately save more lives.
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial consultation or a second opinion, call us 24/7 at 877-460-4673.
About the Authors
Walter Stadler, M.D., is Chief Clinical Officer at City of Hope Cancer Center Chicago, where his work is centered on ensuring every person receives the compassionate, high-quality cancer care they deserve. With more than 30 years of experience, he is a medical oncologist that specializes in the treatment of prostate, kidney, testicular and bladder cancers.
Scott McLellan is Executive Director of The Julian Grace Foundation and a respected community leader dedicated to advancing opportunity, education and health equity. A longtime nonprofit leader, he has spent his career building trusted community partnerships and advancing programs that improve the wellbeing of individuals and families across the region.