Prostate Cancer in U.S. Hispanic Men
Hispanic Heritage Month runs from September 15 to October 15. Below, Dr. Scarlett Gomez, a professor of epidemiology and biostatistics at the University of California, San Francisco, and an expert on cancer disparities, describes how prostate cancer is affecting Hispanic/Latino men.
- Prostate cancer remains a significant burden for Hispanic/Latino men in the U.S.
- Hispanic/Latino men may have barriers to prostate cancer screening. They are less likely to have a regular doctor and may not have access to educational materials about prostate cancer and PSA screening in their preferred language.
- When they are diagnosed, Hispanic/Latino men may be less likely to receive optimal treatment.
- Research has identified many of the reasons for these gaps in care, and they can be addressed.
PCF remains committed to identifying and overcoming disparities in prostate cancer care. PCF researchers are leading efforts to define the genetics of prostate cancer risk in Latino men and strategies to increase recruitment of minorities, including Spanish-speaking patients, into prostate cancer clinical trials.
This month is Hispanic Heritage Month, and an opportunity to call attention to and awareness of prostate cancer in this community. Prostate cancer is the most commonly diagnosed cancer among Hispanic/Latino men in the U.S., comprising more than 1 in 5 of all new cancer diagnoses, and contributing nearly 14,000 new diagnoses and 2,000 deaths annually. Of concern, despite a decade or more of declining rates, incidence rates of advanced prostate cancer appear to be increasing over time among Hispanic/Latino men, a similar pattern seen among other racial/ethnic groups.
Although deaths due to prostate rank below lung, liver, and colorectal cancer among Hispanic/Latino men, the morbidity of the disease and its treatment is not inconsequential, with many men suffering from difficulties in urinary, bowel, and sexual functioning. Survival for localized disease is generally favorable, however, screening by prostate specific antigen (PSA) is currently the most widely available and acceptable screening modality, and guidelines for screening have shifted considerably over the past decade.
The most current PSA screening guidelines indicate that men should discuss the benefits and risks of screening with their doctors. However, shared decision making for prostate cancer screening may be challenging for Hispanic/Latino men as they may be more likely to experience barriers related to not having a usual source of primary care, lack of availability of in-language materials and care providers, and lack of training for culturally-competent care communications.
In addition to being of lower socioeconomic status and more likely to have public health insurance, Hispanic/Latino men diagnosed with prostate cancer also appear to be more likely to be diagnosed at a younger age, and with higher risk disease. Moreover, a study based on cancer registry data from California showed that Hispanic/Latino men with high risk localized disease are less likely than non-Hispanic White men to receive guideline definitive treatment – radical prostatectomy, radiation (with or without androgen deprivation therapy), or cryoablation. This difference was mitigated by differences in sociodemographic characteristics between Hispanic/Latino and non-Hispanic White men, including marital status, health insurance status, neighborhood socioeconomic status, and care at an NCI-designated cancer center. Although these factors related to access to care and other social determinants indicate an unacceptable disparity in the treatment of Hispanic/Latino men, these factors are also largely addressable.