Even though anyone with a prostate can develop prostate cancer, Black men are at greater risk. According to Memorial Sloan Kettering Cancer Center, "Black men are 50% more likely to develop prostate cancer in their lifetime and twice as likely to die from the disease."
While the reasons for this increased risk haven't been definitively proven, various factors could play a role. We asked Urline Gregoire, a nurse practitioner in our Easton Care Center, to share her insights about Black men and prostate cancer, including screening guidelines and tips for encouraging screening.
As with all content on our blog, the following is educational only, not medical advice. Always consult your physician regarding your unique healthcare needs.
Why are Black men at greater risk for prostate cancer?
URLINE GREGOIRE: Researchers have found several factors that might affect a man's risk of getting prostate cancer. Some risk factors are race/ethnicity, age, family history, and smoking, just to name a few.
Many studies have shown prostate cancer develops more often in African American men and Caribbean men of African ancestry than in men of other races.
Aside from the genetic factor, Black men are also at greater risk for prostate cancer due to a lack of awareness and understanding of the disease. Other factors are social barriers, such as lack of access to quality medical care. Unfortunately, research shows Black men are less likely to receive prostate cancer screening than white men.
In your experience as a nurse practitioner, how aware are your patients about the risk of prostate cancer as it relates to race?
URLINE GREGOIRE: Most of my patients, especially Black men, are often not aware of the correlation of their race to prostate cancer and don't get screened accordingly. Therefore, education is key. We must continue to educate people, especially those at high risk.
What are the current screening guidelines for prostate cancer?
URLINE GREGOIRE: The American Cancer Society recommends that men at average risk for prostate cancer discuss screening with their healthcare provider at age 50. Men at higher risk, such as Black men in general and any man with a first-degree relative who had prostate cancer, should have the conversation at age 45. Black men with a family history of breast, ovarian, or prostate cancer should discuss getting screened at age 40.
Talk about the two main types of prostate cancer screening: digital rectal exams and prostate-specific antigen (PSA) tests.
URLINE GREGOIRE: A digital rectal exam is a quick exam that a medical provider can perform in the office to check for swellings and inflammation of the prostate, which could be an early sign of prostate cancer. Prostate-specific-antigen (PSA) is a blood test that measures the level of prostate-specific antigen in the blood. This is a widely used screening method that can also detect prostate cancer.
Why might Black men forgo or be hesitant about prostate cancer screening?
URLINE GREGOIRE: A few factors might contribute to why Black men often forgo or hesitate about prostate cancer screening. A few common factors are the health stigma and disparities about prostate cancer. Another issue is the distrust of the healthcare system since African Americans' experiences with the healthcare system are often not positive.
Cultural barriers can also play a significant role. For example, in the African American culture, "cancer" is often interpreted as "death." Therefore, Black men might avoid getting screened.
Another cultural barrier I often encounter in my practice is that many patients seek medical care only if symptomatic. Since prostate cancer usually causes no symptoms in the early stages, most of these men do not often prioritize screenings as they do not see the importance of it since they are not feeling ill.
Family members, especially partners, can play a vital role in encouraging their loved ones to get screened. Do you have any tips for helping partners broach the subject?
URLINE GREGOIRE: People must become comfortable talking about prostate cancer. In African American culture, anything below the hip is usually considered a very private matter and often not discussed with anyone—even with their loved ones. Family members, especially wives and daughters, should break the silence by starting a conversation with their husbands, fathers, or even their uncles and encourage them to prioritize their prostate health and get screened.
I would advise not only should they facilitate the conversation to encourage their partners to get screened early, but they should also take the next step to schedule their medical appointments and attend the visit with them.
Is there anything else you'd like to convey about Black men and prostate cancer?
URLINE GREGOIRE: There is a Bible verse that states, "My people are dying due to lack of knowledge" (Hosea 4:6). Being of African descent myself, I often think of this verse in relation to the lack of awareness and understanding of prostate cancer which has become the "silent killer" within my own race. Therefore, as a nurse practitioner, I realized we must focus on bridging the gap between racial and health disparities regarding prostate cancer. Eliminating prostate cancer disparities and removing stigma in African American men will play a crucial role. I would like to encourage all Black men to make their health a priority and get screened since early detection through screening may mean the difference between life and death.
The diagnosis of prostate cancer is not an automatic death sentence, especially when caught in the early stages. Technology has greatly improved, too, which means treatment options have fewer risks and greater outcomes. Lastly, I would advise Black men to join clinical trials and research studies so we can have a better understanding of prostate cancer in African American men.
Bottom line: Prostate cancer screening saves lives.
If you have a prostate, stay vigilant. Request an appointment with one of our world-class urologists, nurse practitioners, or physician assistants to discuss your prostate cancer risks and screening options.