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Low-Income
men more likely to be diagnosed with
Advanced Prostate Cancers
Newswise — Low-income men are more likely to
present with advanced prostate cancers, most
likely because they don’t receive screening
services shown to reduce the diagnosis of
later-stage cancers, a UCLA study found.
The study focused on a group of
disadvantaged men enrolled in the state’s
IMPACT (Improving Access, Counseling and
Treatment for Californians with Prostate
Cancer) program, which provides high-quality
care to poor, underinsured and uninsured
men.
Researchers found that of the 570 men
studied, 19 percent had metastatic cancer at
diagnosis, compared to 4 percent of men from
the general population who were followed in
other studies.
The study also found that the diagnosis
rates for lower-risk, less advanced cancers
in the IMPACT patients did not increase over
time, while the diagnosis rates of
lower-risk, less advanced cancers did go up
for men in more affluent populations.
Previous studies have shown that widespread
adoption of PSA screening for prostate
cancer has resulted in more men being
diagnosed with organ-confined, low-risk
disease.
This trend has not been mirrored among the
disadvantaged IMPACT patients, who don’t
have access to or don’t take advantage of
screening.
Published in the February 2009 issue of The
Journal of Urology, the study sheds light on
the challenges and opportunities that public
assistance programs face in reducing
cancer-related socioeconomic disparities.
“The IMPACT program without question allows
these disadvantaged men to receive high
quality prostate cancer care that they did
not have access to before,” said Dr. William
Aronson, the senior author of the study, a
clinical professor in the UCLA Department of
Urology and a researcher at UCLA’s Jonsson
Comprehensive Cancer Center.
“However, the persistent preponderance of
metastatic and higher risk localized cancers
in these men suggests that more
comprehensive strategies are needed to
eliminate the disparities in prostate cancer
morbidity and mortality.”
With much national attention now focused on
the potential over-diagnosis and
over-treatment of men with prostate cancer,
these findings “serve as a reminder that for
disadvantaged men, under-detection and
under-treatment of prostate cancer remains a
significant concern,” the study states.
In an accompanying editorial, a health
disparities researcher writes that men from
minority groups who live in poverty are more
likely to die of prostate cancer than men
with higher socioeconomic status. Access to
services may prove to be key.
“Improving access to the preventive and
treatment aspects of health care will go a
long way toward reducing the disparities in
disease morbidity and mortality suffered by
poor and minority communities,” writes Dr.
M. Norman Oliver, director of the University
of Virginia Center of Health Disparities.
The study was conducting by researchers from
UCLA, the Jonsson Cancer Center and Dr.
David Miller at the University of Michigan,
IMPACT, administered by staff at UCLA, is
the first and only program of its kind
nationwide to assist underinsured or
uninsured patients in obtaining prostate
cancer treatment.
The program provides access to free,
high-quality treatment through more than 700
medical providers located throughout the
state.
UCLA's Jonsson Comprehensive Cancer Center
comprises about 235 researchers and
clinicians engaged in disease research,
prevention, detection, control, treatment
and education.
One of the nation's largest comprehensive
cancer centers, the Jonsson center is
dedicated to promoting research and
translating basic science into leading-edge
clinical studies.
In July 2008, the Jonsson Cancer Center was
named among the top 10 cancer centers
nationwide by U.S. News & World Report, a
ranking it has held for nine consecutive
years. For more information on the Jonsson
Cancer Center, visit our website at
http://www.cancer.ucla.edu.
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