Black Men Underestimate Prostate Cancer Risk

A substantial proportion of men about to undergo a biopsy for suspected prostate cancer believe it's "impossible" they actually have the disease, a new study shows.

And African American men were much more likely than whites to say there was no way they could have prostate cancer-55 percent estimated that they had zero chance of being diagnosed with the disease, compared with nearly 20 percent of white men.

"Nobody who's sent in for a biopsy should think it's impossible that they have cancer," Dr. William Dale of the University of Chicago, the study's lead author, told Reuters Health. The findings suggest many doctors aren't giving patients enough information about why biopsies are performed, and also point to a "worrisome" lack of concern among at-risk men, he added in an interview.

African American men are at greater risk of prostate cancer than whites, and are also more likely to have aggressive forms of the disease, Dale and his colleagues note. To better understand how both blacks and whites about to undergo biopsies think about their risk, Dale and his team interviewed 93 black men and 96 whites who had been referred for needle biopsies of the prostate at the University of Chicago Medical Center. They presented their findings this month at the American Society of Clinical Oncology's annual meeting in Chicago.

Among the black men, the researchers found, 55 percent gauged their risk of prostate cancer to be 0 percent, while nearly all said their risk was less than 50 percent. However, 70 percent turned out to have prostate cancer.

The researchers found no link between education, income level, or the presence of symptoms and whether or not a man judged his risk accurately. But men who reported being more anxious about prostate cancer made closer estimates of their risk.

It's possible that prostate cancer simply isn't high on the list of African American men's worries, while men who say they don't think they could possibly have the disease may be expressing "hopefulness," Dale said. "I'm just speculating on that. We don't actually know."

Doctors should also be more diligent about discussing biopsies with their patients, he added. "Sort of a quick over-the-phone thing that says 'get a biopsy,' I don't think is appropriate," Dale said. "I would urge patients to push their doctors on what does this mean when they say they have to have follow-up testing."

Simply giving people more information probably isn't enough, he added. "We often emphasize that people need to be more informed and that it's an information problem...it's as much an emotional and a psychological issue to make them be motivated."

Prostate Cancer Foundation