Diversity in prostate cancer – Filling the equity gap
Black men face significantly higher risks of developing and dying from prostate cancer compared to Caucasian men — a disparity rooted in both biological and systemic inequities. The Diversity in PCa PROMS Study, led by the European Association of Urology, aims to address this by gathering patient-reported outcomes from Black men to improve care and ensure more equitable treatment.
The Lifespan Gap
Prostate cancer affects many men, but the disparity in outcomes for Black men is striking and raises deeper questions about health equity. One in four Black men will develop prostate cancer in their lifetime, compared to one in eight Caucasian men. [1]
However, it's not just the diagnosis itself that is revealing —it's the life lost prematurely, with Black men being nearly twice as likely to be diagnosed with prostate cancer as Caucasian men, and 2.1 times more likely to die from it. [2] This creates a significant lifespan gap, where the quality of life, as well as the years lived, are altered by a disease that hits harder for Black men.
Why does this gap exist?
The gap is more than just a statistic — it reflects deep-rooted historical, social, and medical inequities, from the underrepresentation of Black people in clinical trials to a legacy of mistreatment and ethical violations in healthcare. Prostate cancer is often seen as a taboo topic, and shame around ‘losing masculinity’ can lead men to avoid seeking help, resulting in later diagnoses.
While biological factors like higher Gleason scores and elevated prostate-specific antigen (PSA) levels contribute to the difference, the deeper question is why these disparities in prostate cancer between Black men and Caucasian men still persist today. The lifespan gap isn't merely because of biology—it's a mirror to the broader issues of healthcare accessibility, trust, and societal inequality that continue to shape the experience of Black men in ways that are far from equitable.
What can be done?
A Patient Reported Outcome Measurement (PROMS) study collects and analyses direct feedback from patients about how they feel in relation to their health condition and treatment — without clinician interpretation. PROMS studies provide unique insights into treatment effects from the patient's perspective, which allow for more personalised and efficient care.
Diversity in PCa PROMS Study
The Patient Office at the European Association of Urology is currently leading a PROMS Study titled ‘Diversity in Prostate Cancer (PCa)’, which collects health outcomes directly from underrepresented communities, that is, Black men of African and Caribbean descent. The questionnaire will focus on quality-of-life after treatment for prostate cancer, with an emphasis on equity in patient care.
To ensure the voices of Black prostate cancer patients are respectfully amplified, the Diversity in PCa PROMS Study is a collaborative effort between multiple Black community stakeholder groups, such as Cancer Black Care (CBC) and CancerUK Salone, among others, as well as Prostate Cancer UK (PCUK) and Prostate Cancer Research UK (PCR).
The Aim of the Study
Findings from the Diversity in PCA PROMs Study have the potential to shape legislation and clinical guidelines, influencing how healthcare providers deliver care. They could also raise vital awareness about the importance of early screening and detection for Black men.
Prostate cancer itself does not discriminate. We should view ourselves as one community with a shared goal: to combat prostate cancer.
[1] ‘Why does our latest TV advert say Black men’s risk is ‘double’?’, Prostate Cancer UK, [https://prostatecanceruk.org/about-us/news-and-views/2024/05/black-men-s-risk?]
[2] Supra