ZERO – The End of Prostate Cancer explores health disparities in prostate cancer and how organizations like ZERO are working to achieve health equity.
Reginald Tucker-Seeley, Sc.D
Vice President of Health Equity, ZERO
A recent report from the American Cancer Society highlights improvements in overall trends for cancer incidence and mortality. However, disparities remain for most cancers. Cancer disparities are differences in cancer-related outcomes (e.g. screening/detection, diagnosis, and mortality) that are preventable, avoidable, and unjust. We see these differences across racial groups, where white people generally have better outcomes compared to racial minorities, and those with access to early detection and high-quality curative care have better outcomes compared to those without such access.
It is often assumed that these disparities are driven primarily by differences in socioeconomic status; yet research has shown that disparities in cancer persist even when socioeconomic status is similar across racial groups, where racial minorities are less likely to receive high-quality healthcare than white people even when health insurance status, age, severity of disease, and health status are comparable.
Black people generally have worse outcomes for most cancers compared to other racial/ethnic groups. One of the most notable of those differences is the disparity experienced in prostate cancer by Black men, where Black men are almost 1.5 times more likely to be diagnosed with prostate cancer and over two times more likely to die from this disease. As we highlight the lives and achievements of Black Americans during Black History Month, we also have an opportunity to highlight the tools/resources that our community needs to eliminate racial disparities in our health and achieve health equity.
Achieving health equity
Health equity in prostate cancer means that everyone has a fair and just opportunity to find, treat, and survive prostate cancer. At ZERO – The End of Prostate Cancer, we developed the Black Men’s Prostate Cancer Initiative to increase education/awareness, provide support, and collaborate on research activities to eliminate the disparity that Black men experience in prostate cancer. Our efforts include a support group for Black men diagnosed with prostate cancer; a Prostate Cancer in the Black Community film series; and a collaboration on a Robert Wood Johnson Foundation-funded project to create a Learning Community of black male prostate cancer patients, healthcare providers (primary and specialty), and healthcare system administrators with a common goal of identifying and addressing inequitable care in the prostate cancer care delivery system.
Given the longstanding presence of cancer disparities generally and prostate cancer disparities specifically, it can feel like an insurmountable task to eliminate these differences. Nevertheless, we will continue to see these differences unless we approach the elimination of such disparities by targeting multiple levels. At ZERO, we’re calling for the following from patients and families, healthcare providers, and policymakers:
Patients/Families: Try to have a usual source of healthcare with a provider you trust, and start talking to your provider about prostate cancer screening at age 40.
Healthcare Providers: Be trustworthy partners to Black men as we navigate the healthcare delivery system generally and the cancer care delivery system specifically. Be cognizant of how our social contexts (where we live, learn, and work) influence how we enter and navigate the healthcare delivery system.
Policymakers: Remove financial barriers to screening and address the financial toxicity of cancer throughout survivorship.
Of course, we recognize that these efforts alone won’t eliminate racial disparities in prostate cancer and that implementation of these efforts also includes barriers to surmount. However, by calling attention to the multiple levels (i.e. patients, healthcare providers, and policymakers), we are highlighting that disparity elimination is not only about equipping individuals and their families with the information and knowledge they need to prevent and screen for, but it’s also about making changes to the healthcare delivery system to eliminate the effects of historical and contemporary racism.
As the saying goes, “a bad system will beat a good person every time.” To ensure that we finally eliminate racial disparities in prostate cancer, let’s all commit during this Black History Month to choose health equity so that all patients and their families get the high-quality care they need, when they need it.