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VA RESEARCH ON LOW-INCOME MEN AND
ADVANCED
PROSTATE CANCER -- Researchers report that more
low-income men go undiagnosed until their
prostate
cancer has reached more advanced stages.
For more about VA research, use the VA Watchdog
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arch.php?q=va+research&op=ph
Story here...
http://esciencenews.com/arti
cles/2008/12/16/low.income.men.diagnosed.m
ore.often.with.advanced.prostate.cancer
Story below:
Your comments accepted at bottom of
page.
-------------------------
Low-income men diagnosed more often with advanced
prostate cancer
Health & Medicine
Coincident with the widespread adoption of PSA screening, the proportion
of American men diagnosed with organ-confined, low risk prostate cancer
has increased significantly during the last two decades. In a study
scheduled for publication in the February 2009 issue of The Journal of
Urology, researchers report that for low-income men, the opposite is true,
with more men undiagnosed until
 their
cancers had reached more advanced stages. Examining the records of 570
disadvantaged men from the California IMPACT (Improving Access, Counseling
and Treatment for Californians with Prostate Cancer) program designed to
provide high-quality care for prostate cancer patients, the authors from
the University of Michigan, University of California, Los Angeles, UCLA's
Jonsson Comprehensive Cancer Center and the Veterans Administration,
Greater Los Angeles Healthcare System, found that 19% of these men had
metastatic cancer at diagnosis, in contrast to approximately 4% of men
from the general population tracked in other studies. Further, the
diagnosis rate for low-risk, less advanced cancers in the IMPACT patients
did not increase, also in contrast with a significant rise in these
diagnoses in the more affluent population.
The proportion of men in the program presenting with metastatic cancer did
not change over time, indicating that low-income men were not receiving
prostate cancer screening services that have been shown to reduce the
diagnosis of late-stage cancers in the general population.
Writing in the article, David C. Miller states, "Our principal findings
clarify some of the challenges (and opportunities) faced by public
 assistance
programs designed to reduce cancer related disparities. Without question
IMPACT enables eligible men to receive previously unattainable—and high
quality—prostate cancer care…However, from a population perspective the
persistent preponderance of metastatic and higher risk localized cancers
suggests that more comprehensive strategies are needed to eradicate
socioeconomic disparities in prostate cancer specific morbidity and
mortality. …" while much attention now focuses on potential overdiagnosis
and overtreatment of men with screen detected prostate cancer, our
findings serve as a reminder that for disadvantaged men underdetection and
undertreatment of prostate cancer remain significant concerns."
In an accompanying editorial, M. Norman Oliver of the University of
Virginia School of Medicine comments that men from minority groups who
live in poverty and are diagnosed with prostate cancer are more likely to
die of their disease than those men with a higher socioeconomic status. He
writes, "However, we must address more than socioeconomic disparities in
prostate cancer care…African-Americans have a disproportionately high rate
of poverty with some 25% living below the federal poverty level compared
to 8% of the white population in that category. This racial disparity in
combination with the socioeconomic disparity already discussed places
African- American men diagnosed with prostate cancer at an even greater
risk of presenting with incurable disease."
-------------------------
posted by Larry Scott
Founder and Editor
VA Watchdog dot Org
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