Certain Latino and Hispanic Men More Likely to Be Diagnosed With High-Risk Prostate Cancer

Institution Partners | Cancer Centers | <b>Sylvester Comprehensive Cancer Center</b>

Despite Latino and Hispanic men being more likely to present with higher-risk prostate cancer, they are less likely to receive treatment for their disease compared to other ethnicities.

Recent study findings have built on prior data that have shown that Hispanic and Latino men tend to have poorer prostate cancer outcomes.

This study demonstrated that Mexican men, in particular, are at an even greater risk for developing advanced-stage disease. The findings also indicated that this same group of men are less likely to receive treatment for their disease.

Study author, Dr. Brandon Mahal, an assistant professor of radiation oncology at the University of Miami Sylvester Comprehensive Cancer Center, spoke with CURE® about the study’s findings, and what Hispanic and Latino men need to know about prostate cancer risk.

CURE®: Why is it important to research prostate cancer disparities?

Mahal: So the research I do focuses on cancer disparities, in particular, prostate cancer disparities. For prostate cancer, specifically, there are only three well-established risk factors: older age, family history and race and ethnicity. When unpacking those factors, there's a lot that could go into race, ethnicity being that it's a social construct, that's largely determined by social determinants of health. There's a lot of complicated factors that may contribute to that one factor.

This study was inspired by the fact that race and ethnicity is a risk factor for prostate cancer for both developing disease and developing more aggressive disease. And what we know, in general about Latino populations is that it's a very heterogeneous group. And what we were interested in is whether or not there might be differences and presentation with aggressive disease, for men with prostate cancer, and also whether or not there might be differences by treatment status for Latino/Hispanic men with prostate cancer across country of origin.

We used a large, national database that included just under 900,000 men with prostate cancer. And what we did is we examined the risk of the odds of presenting with high-risk disease and also the odds of being treated for high-risk prostate cancer.

What were the findings?

Latino and Hispanic men, in general, were 18% more likely to present with higher-risk disease. And despite being more likely to present with higher-risk disease, they were a little over 30% less likely to receive treatment for that higher-risk disease across the United States.

When further dissecting those results, what we found is that when disaggregating the groups by country of origin, there were particular groups who were at higher risk, and most notably, Mexican men were the most likely to present with aggressive disease.

Why do these disparities exist?

The leading hypothesis is that this is probably largely driven by socio-cultural factors and also potentially some contribution of ancestry. We know that men with West African ancestry are more likely to present with higher-risk prostate cancer, and there there's some admixture in there from with a lot of Latino men having some West African ancestry. So there could definitely be ancestral components.

But we do think that this is largely due to social cultural factors including the odds of getting screened to begin with. Early prostate cancer screening is very important to present with earlier-stage disease. And then once diagnosed with prostate cancer, we know that there are various factors that are barriers to treatment, including access to care (like) insurance coverage, having access to treatment facilities.

We know for all of those various factors that Latino and Hispanic men are less likely to have good access to care. And so ultimately, we feel that these findings highlight some of those factors, most notably that Latino men are less likely to be screened for prostate cancer and less likely to be treated for prostate cancer due to these issues.

What is your advice for Latino men?

I recommend that all Latino men who are reading this article and families of Latino men should know that there's a very effective screening test for prostate cancer. It's a simple blood test, the PSA or prostate-specific antigen blood test. And that blood test helps us detect prostate cancer before it becomes an issue, and before you can even experience symptoms. It helps us detect prostate cancer when it's at a curable stage. When prostate cancer is detected by PSA screening, there's a greater than 90% chance that that cancer can be cured.

When prostate cancer is detected in late stages, there's a less than 20% chance that there's survival beyond five years. And so it's very important to get early screening, and by early screening, I mean by age 50, all Latino men should be considering PSA screening. And if men have a family history of prostate cancer, especially a family history of aggressive prostate cancer, they ought to be considering PSA screening at age 45.

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