Prostate Cancer Death Rate Higher Among Blacks in Most Big Cities
Greatest racial disparity found in Los Angeles, the least in Minneapolis.
Black men die from prostate cancer (PCa) at a significantly higher rate than white men in the United States, and the degree of this racial disparity varies considerably across cities, new study findings suggest.
At the national level, the PCa death rate during 2005–2009 was nearly 2.4 times higher among black men than white men. The city with the least disparity was Minneapolis, where the rate of PCa death was 13% higher among black men than white men, a non-significant difference, Maureen R. Benjamins, PhD, of the Sinai Urban Health Institute in Chicago, and colleagues reported in Cancer Epidemiology (2016;44:125-131). The city with the greatest disparity was Los Angeles, the nation's second-most populated city, where the PCa death rate was 3.24 times higher in blacks than whites, a statistically significant difference.
During 2005–2009, the PCa mortality rate in New York and Chicago, the largest and third-largest US city by population, was 2.75 times and 2.61 times higher among blacks than whites, respectively.
“This type of specific city-level data can be used to motivate public health professionals, government officials, cancer control agencies, and community-based organizations in cities with large or increasing disparities to demand more resources, focus government efforts, and implement effective policy and programmatic changes in order to combat this highly prevalence condition,” Dr Benjamins' team concluded.
The investigators analyzed PCa mortality data from 1990–1994 and 2005–2009. They included 41 of the nation's largest cities in their analysis. The PCa mortality rate declined for both races over the 20-year period from 1990 to 2009, but still remained higher for blacks than whites in most cities. During 1990–1994, blacks had a statistically significant higher PCa death rate than whites in all but 2 cities (Las Vegas and Fresno, CA). During 2005–2009, blacks had a statistically significant higher PCa death rate than whites in all but 4 cities (Minneapolis, Las Vegas, Portland, OR, and Sacramento, CA).
In 1990–1994, the PCa mortality rate among blacks in Memphis was 1.91 times higher than among whites. This rate was 3.18 times higher in 2005–2009, making it the city with the second largest racial disparity and the city that experienced the largest increase in racial disparity among the 41 cities.
Due to the racial disparity, an estimated 2820 annual excess PCa deaths nationwide occurred among black men during 2005–2009, according to the investigators. The number of annual excess black deaths from PCa during the same period was 62 in Los Angeles, 172 in New York, and 109 in Chicago, the investigators reported.
The investigators found no association between socioeconomic factors, such as education and income at the city level, and PCa mortality disparities, but the level of disparity within a city was associated with the degree of black segregation, according to the researchers.