| October 2, 2003
Penn Study to Determine Why African-American
Males Have Worse Outcomes from Prostate Cancer
Determining the Factors that Create Health Disparity
May Improve Clinical Outcomes
(Philadelphia, PA) - Compared with
Caucasian, Asian, or Hispanic men, African-American
men have the highest incidence of prostate cancer in
the world, are stricken at a younger age and, once diagnosed,
are more likely to suffer bad outcomes from the disease
- including death, impotence and incontinence.
To understand why African Americans have poorer outcomes
when they are diagnosed with prostate cancer, the National
Cancer Institute has awarded an $8.5 million grant to
Timothy R. Rebbeck, PhD, Leader of the Cancer
Epidemiology and Risk Reduction Program of the Abramson
Cancer Center of the University of Pennsylvania,
and an Associate Professor of Epidemiology and Biostatistics
at Penn's School of Medicine.
The five-year study will enable researchers to determine
what factors influence bad outcomes among African-American
men and how these factors may influence the disparity
that exists among African-Americans and men of other
"There may be many factors that contribute to poor
outcomes from prostate cancer among African-American
men," said Rebbeck. "We hope to better understand the
factors that contribute to these outcomes and, as a
result, develop better tools to prevent or treat the
disease than we have today."
Researchers at Penn will conduct four separate studies
concurrently over five years. One study will collect
data on the racial, ethical and sociological beliefs
related to prostate cancer awareness and screening:
such as, "Why do African-American males avoid screening
for prostate cancer?" and, "Why do they avoid discussing
the disease with their physicians?" Is it because they
fear the test results or are embarrassed about having
the test, or is there distrust of the medical community?
It is likely that these disparities result from a combination
of many factors.
Another study will evaluate the biological profiles
of African-American men as compared to other races.
Analyses will be performed to study differences in specific
candidate genes that may predispose African-American
men to poor prostate cancer outcomes.
A third study will evaluate the physical environment
of African-American men to determine if certain factors
limit their access to health care and the referring
patterns for cancer care among physicians treating this
group. Treatment patterns will be examined to see if
there are racial disparities in the diagnosis and treatment
of prostate cancer: i.e., are African-American men with
prostate cancer receiving surgery, or opting, instead,
for radiation therapy? Cases will also be re-examined
to see if physicians are recommending the proper treatment.
A fourth study will evaluate patient behavior to determine
whether lifestyle impacts the manner in which African-American
men seek care and treatment for the disease: i.e., do
social networks, such as family and friends, play a
helping role in recovery from prostate cancer and following
through with their physician's instructions?
The studies will gather information from thousands
of men recruited from the University of Pennsylvania
Health System and through the Philadelphia Veterans
Affairs Medical Center. Also, in a partnership with
the Philadelphia chapter of the National Black Leadership
Initiative on Cancer, information about study participation
and research results will be distributed to targeted
"Our densely-populated, urban location provides a close-up
look at just how devastating prostate cancer is to the
community," said Rebbeck. "These studies will make it
possible to directly affect the health of our community
if they help us better define methods of cancer prevention
and treatment for a segment of society that historically
has suffered disproportionately from this disease."
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The Abramson Cancer Center of the University
of Pennsylvania was established in 1973 as a center
of excellence in cancer research, patient care, education
and outreach. Today, the Abramson Cancer Center ranks
as one of the nation's best in cancer care, according
to US News and World Report, and is one of the top five
in National Cancer Institute (NCI) funding. It is one
of only 39 NCI-designated comprehensive cancer centers
in the United States. Home to one of the largest clinical
and research programs in the world, the Abramson Cancer
Center of the University of Pennsylvania has 275 active
cancer researchers and 250 Penn physicians involved
in cancer prevention, diagnosis and treatment.