A new study in JAMA Oncology adds to the growing body of evidence showing there are stark racial disparities in the American healthcare system. The study found Black men who have surgery for prostate cancer are more likely to have complications and have higher out-of-pocket costs than white men.
Study author Dr. Quoc-Dien Trinh, of Harvard Medical School and Brigham and Women’s Hospital, said it questions the idea that Black people are more genetically prone to prostate cancer. Trinh said prostate cancer might be killing more Black men because it was not being treated properly.
“My interpretation is that all this talk about Blacks having more biologically aggressive disease and hence worse survival may in fact be more of an access to care or access to treatment problem,” Trinh said in an email to Reuters.
Some of the other findings from the survey include the revelation that only 59 percent of Black men had surgery within 90 days of their diagnosis, compared to 70 percent of white men. This may be from a combination of lack of education or Black men not trusting doctors. The study also found the top 50 percent of Black men spent about $1,200 more in out-of-pocket costs than the top 50 percent of white men.
Dr. Otis Brawley, chief medical officer of the American Cancer Society and an oncologist at Emory University, wrote an editorial accompanying the study. He said another problem is that when diagnosed, Black men may not end up being treated by a urologist who specializes in prostate cancer. Brawley said specialists see a high number of cases and get more experience in treating them. A prostate cancer specialist can do three or four prostatectomies in a week, while some doctors only do that many in a year.
Black men may also face problems with transportation, getting referrals, transferring to a specialist and navigating through a complex health system.
“There are some social impediments to getting to those specialists even when one has insurance,” Brawley said.
The research team studied health outcomes of more than 25,000 men, including more than 2,000 Black men, who were insured by Medicare. All had localized tumors and opted to undergo surgery from 1992 to 2009.
As previously reported by Atlanta Blackstar, Black children were less likely to be given pain medication than white children. A study in JAMA Internal Medicine found that Black, brown, less educated and unemployed people waited 25 percent longer to see a healthcare professional.
However, when health disparities are eliminated Black people tend to thrive. A study in Circulation, the journal of patients in the U.S. Department of Veterans Affairs system, found that when Blacks and whites get exactly the same treatment, Blacks do better.