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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 races.

"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 communities.

"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.


Release available online at http://www.uphs.upenn.edu/news/News_Releases/oct03/prostate.htm