Racism and Prostate Cancer in African-American Men

Men of African descent have long been noted to be at increased risk of getting and dying of prostate cancer. While there are some biological reasons suggested to explain this, such as having lower levels of vitamin D, the much more likely explanation is systemic racism in the US health-care system. A study in 2019 found that when black and white men have equal access to medical care, their outcomes for prostate cancer are no different.

Large trials of screening for prostate cancer have failed to include black men at levels commensurate to their representation in the population, and arguably not mirroring the known fact  that they are at higher risk. This may well stem from prior episodes of racism in medicine, such as the infamous Tuskegee experiments in which African-American men with syphilis were denied treatment (or given placebos and told they were actually drugs) to observe the effects of the disease. These and many other terrible experiences have led to low levels of trust in the black community for medical research. The medical community is reaping as they have sown.

References

Antwi S, Tucker TC, Coker AL, Fleming ST. Racial disparities in survival after diagnosis of prostate cancer in Kentucky, 2001-2010. Am J Mens Health 2013;7(4):306-316.

Dess RT, Hartman HE, Mahal BA, et al. Association of black race with prostate cancer-specific and other-cause mortality. JAMA Oncol 2019;5(7):975-983.

Krishna S, Fan Y, Jarosek S, Adejoro O, Chamie K, Konety B. Racial disparities in active surveillance for prostate cancer. J Urol 2017;197(2):342-349.

Pinsky PF, Ford M, Gamito E, et al. Enrollment of racial and ethnic minorities in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. J Natl Med Assoc 2008;100(3):291-298.