The study focused on a group of disadvantaged men enrolled in the California’s IMPACT (Improving Access, Counseling and Treatment for Californians with Prostate Cancer) programme, which provides care to poor, underinsured and uninsured men. Researchers found that of the 570 men studied, 19 percent had metastatic cancer at diagnosis, compared to four percent of men from the general population who were followed in other studies.
The study also found that the diagnosis rates for lower-risk, less advanced cancers in the IMPACT patients did not increase over time, while the diagnosis rates of lower-risk, less advanced cancers did go up for men in more affluent populations.
Previous studies have shown that widespread adoption of PSA screening for prostate cancer has resulted in more men being diagnosed with organ-confined, low-risk disease. This trend has not been mirrored among the disadvantaged IMPACT patients, who do not have access to or do not take advantage of screening.
"The IMPACT programme without question allows these disadvantaged men to receive high quality prostate cancer care that they did not have access to before," said Dr. William Aronson, the senior author of the study. "However, the persistent preponderance of metastatic and higher risk localised cancers in these men suggests that more comprehensive strategies are needed to eliminate the disparities in prostate cancer morbidity and mortality."
With much national attention now focused on the potential over-diagnosis and over-treatment of men with prostate cancer, these findings "serve as a reminder that for disadvantaged men, under-detection and under-treatment of prostate cancer remains a significant concern," the study states.
MEDICA.de; Source: University of California - Los Angeles