Prostate Cancer May Be Underdiagnosed in Poor Men-- A. Agrawal, PhD
Monday, January 26, 2009
MONDAY, Jan. 26 (HealthDay News) -- Although the detection of low-risk prostate cancers has been increasing in the United States due to screening, this is not the case among low-income, disadvantaged men, researchers report in the February issue of the Journal of Urology.
David C. Miller, M.D., and colleagues from the University of California Los Angeles retrospectively examined trends in prostate cancer severity in 570 low-income, ethnically diverse uninsured men with prostate cancer served by a state-funded public health program in California from 2001 to 2006.
The researchers report that at diagnosis, 51 percent of men had prostate-specific antigen levels greater than 10 ng/mL, 50 percent had a Gleason score of at least 7 and 43 percent had clinical T stage T2 or greater. At diagnosis, 19 percent of cancers had metastasized, which remained stable with time, the investigators found. Among non-metastatic cancers, 24 percent had low-risk features, which also remained stable over time, the report indicates.
"Unlike the broader United States population, the proportion of disadvantaged men with organ confined, low-risk prostate cancer has not been increasing," Miller and colleagues conclude. "Thus, while much attention focuses on potential overdiagnosis and overtreatment of men with screen-detected prostate cancer, our findings suggest that for low-income, uninsured men, underdetection and undertreatment remain significant concerns."
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