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Statement on Prostate Specific Antigen National Medical Association’s Urology Section’s Experts

Significant racial disparities exist for African American men diagnosed with prostate cancer. In fact, African American men have a 60% higher incidence of the disease and 2-fold higher mortality compared to other ethnic groups in the United States.

 
PRLog - Nov. 16, 2011 - Prostate cancer continues to pose a significant health concern in the United States.  It is estimated that 240,890 American men will be diagnosed with prostate cancer in 2011.  Additionally, approximately 33,720 men are expected to succumb to this disease. It is second only to lung cancer in cancer-related deaths.1  

Significant racial disparities exist for African American men diagnosed with prostate cancer. In fact, African American men have a 60% higher incidence of the disease and 2-fold higher mortality compared to other ethnic groups in the United States. Efforts at early detection of the disease are particularly critical in African American men as they are  approximately 3 – 4 times more likely to present with distant and incurable cancer than Caucasian men.2,3

Recently, there have been concerns that PSA screening results in over diagnosis and overtreatment of prostate cancer along with harmful effects to patients. Recommendations have been made by a federal panel to limit the use of PSA as a screening test. These recommendations are primarily based on observations from large clinical studies performed in Europe, Canada, and the United States; very few African American men participated in these studies. As a result, the findings of these studies may not be generalizable to the African American community.

Since PSA testing was initiated, a clear trend toward declining mortality rates among prostate cancer patients has been observed. Although PSA screening cannot readily separate aggressive from indolent cancers, it currently represents the best method to detect early stage, curable prostate cancers. The R. Frank Jones Urological Society and the Urology section of the NMA therefore support the use of PSA in the early detection of prostate cancer as a means to support health promotion in African American men, and other high risk individuals including men of African and Caribbean descent. Moreover, we endorse the American Urologic Association’s best practice statement on prostate cancer early detection, which includes:
1.      Initial PSA testing at 40 years
2.      Both DRE and PSA as part of screening
3.      An informed decision making process
4.      A multi-factorial assessment of risk based on age, ethnicity, family history, PSA kinetics  and density.

In keeping with the NMA’s mission, the Urology Section also strongly supports a community based approach to early detection of prostate cancer that features education, improved access, and patient-provider dialogue, as well as the promotion of health seeking behavior in underserved populations.

The Urology Section of the NMA includes African American urologists in academia, private practice, and in the military. Our mission is to eliminate health care disparities in urologic diseases among underserved populations through education, research, legislation and diversity. The NMA was created in 1895 to represent the interests of African-American physicians.  As the leading force of parity and justice in medicine and the elimination of disparities in health, the NMA is committed to improving the health status and outcomes of minorities and the underserved.  While the NMA has historically focused on health issues related to African American’s, its principles, goals, initiatives, and philosophy address and benefit improved health for all Americans.

References
1. Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 2011;61:212-36.
2. Powell IJ, Bock CH, Ruterbusch JJ, Sakr W. Evidence supports a faster growth rate and/or earlier transformation to clinically significant prostate cancer in black than in white American men, and influences racial progression and mortality disparity. J Urol 2010;183:1792-6.
3. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Limited-Use, Nov 2007 Sub (1973-2005)  - Linked To County Attributes - Total U.S., 1969-2005 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2008, based on the November 2007 submission.


Cheryl T. Lee, MD, Chair of the Urology Section of the National Medical Association -
Dr. Lee, MD is currently an Associate Professor of Urology at the University of Michigan where she is the Robert H. and Eva M. Moyad Professor of Urology.  Dr. Lee is dedicated to improving the care of bladder cancer patients through advocacy, education and research. She has served as President of the Scientific Advisory Board of the Bladder Cancer Advocacy Network as well as Vice Chairman, Chairman, and currently, Past-Chairman of the Bladder Cancer Think Tank.   Dr. Lee is active in the education of urologists maintaining a postgraduate course at the annual meeting of the American Urological Association (AUA), and has served on the AUA Curriculum Committee, the AUA Program Committee, and the ABU/AUA Examination Committee. She remains an active member of the Board of Directors of the Society of Urologic Oncology and has served as Treasurer, Secretary, Vice President, and currently, as President of the National Medical Association’s Urology Section.

Cedric M. Bright, MD, FACP, President of the National Medical Association
Dr. Bright, MD,  serves as the 112th President of the National Medical Association.  Dr. Bright is the Assistant Dean of Special Programs and Admissions in the Department of Medical Education at the University of North Carolina at Chapel Hill School of Medicine.  He is a graduate of Brown University and the University of North Carolina at Chapel Hill School of Medicine.  He completed his residency training at Rhode Island Hospital/Brown University.  
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Founded in 1895, the National Medical Association is the nation’s oldest and largest medical association representing the interests of more than 50,000 African American physicians and the patients that they serve. The NMA repeatedly advocates for policies that would assure equitable and quality health care for all people. To learn more about “We Stand with You:  NMA Physicians and Their Patients United for Improved Health for All”, visit www.westandwithyou.com.

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