Risk Factors for Prostate Cancer Differ Between Native- and Foreign-Born Black Men

Thomas R. Collins

October 03, 2010

October 4, 2010 (Miami, Florida) — Significant differences in prostate cancer risk factors exist between black men born in the United States and those born in African nations or the Caribbean who now live in the United States, according a study presented here at the Third American Association for Cancer Research Conference on the Science of Cancer Health Disparities.

In a survey-based study of more than 3000 black men, researchers at the University of Florida, in Gainesville, found that black men born in the United States reported eating more red meat (46% of respondents) than those born in either African (29%) or Caribbean nations (26%; P < .001).

They also found that even though black men born in the United States are more likely to have health insurance (65.2%) than foreign-born (56.8%) and Caribbean black men (64.4%; P = .014 ), African-born men are the more likely to regularly discuss prostate cancer prevention with a doctor (41%) than American-born black men (50.1%; = .022).

Of the 3040 respondents who identified their ethnicity, 2405 were native-born, 315 were African-born, and 320 were Caribbean-born.

Folakemi Odedina, PhD, professor of pharmaceutical outcomes and policy at the University of Florida, who led the study, said the findings refute a common belief among physicians that "black is black."

"What we are finding is that risk factors are different," she told Medscape Medical News. "When you pool all those people, then you are confusing [risk profiles]."

Research on differences among native- and foreign-born black men, she said, is necessary, especially in light of the healthy immigrant effect, which proposes that when immigrants arrive in the United States, they are healthier than their counterparts already in the United States. Studies have focused on this effect in Asians and Hispanics, but not in blacks, she said.

The study also found that similar numbers of black men in all 3 groups reported undergoing annual physicals — with no statistical difference — even though significantly more American-born black men reported having health insurance.

In addition, 70.7% of American-born black men reported eating meat at least 4 to 6 times a week, compared with 64.2% of African-born and 61.8% of Caribbean-born black men (P < .001).

Levi Garraway, MD, PhD, assistant professor in the Department of Medicine at Harvard Medical School in Boston, Massachusetts, who moderated the session, said the study might be the beginning of more awareness of a new meaningful level of understanding about cancer risk.

"This is one of those things where it's the beginning of looking at this," he said. "I hadn't personally thought about that level of complexity."

"In terms of the actual data that [Dr. Odedina] presented, it's not totally clear that . . . there's something obvious to do differently," Dr. Garraway said. "I think it's more that the levels of awareness of the risk for prostate cancer and how aggressive the patient will be in talking to the physician may vary, and that these different regions may influence that to a certain degree."

The findings might be a sign that early action is needed to minimize risk, he said.

"What the findings do is give you a sense of whether the point of intervention falls within the physician's office or falls somewhere else in the community," Dr. Garraway said. "The limiting point of intervention might be even before they arrive into the healthcare system."

The study received no commercial financial support. Dr. Odedina and Dr. Garraway have disclosed no relevant financial relationships.

Third American Association for Cancer Research Conference on the Science of Cancer Health Disparities (SCHD): Abstract PR-2. Presented October 1, 2010.

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