Jay H. Fowke, PhD, MPH, MS, chief, Division of Epidemiology, professor of preventive medicine, University of Tennessee Health Science Center, discusses factors that can lead to disparity in access to prostate cancer care.

 State of the Science Summit™ on Genitourinary Cancers, Walter Rayford, MD, of West Cancer Center presented a study analyzing the disparity in risk and outcomes between Caucasian and African-American patients with prostate cancer. Sparked by this cutting-edge presentation, Fowke shared insight on some key factors that could play into this.

Access is a crude word that can mean several different things, says Fowke; it could deal with transportation to the clinic or lack thereof, or the patient simply not interested in traveling to a distant facility to receive care. In many cases, insurance companies will only pay for treatment at a larger hospital as opposed to a local clinic, and there are several hurdles a patient needs to overcome to receive treatment.

Currently, there is a lot of ongoing work trying to address this issue, particularly for patients with complicated diseases, Fowke says. Some solutions may involve increasing access to rural areas through telemedicine or improving insurance coverage.

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Jay H. Fowke, PhD, MPH, MS, chief, Division of Epidemiology, professor of preventive medicine, University of Tennessee Health Science Center, discusses factors that can lead to disparity in access to prostate cancer therapy.

Identifying Factors That Limit Access to Prostate Cancer Therapy

Jay H. Fowke, PhD, MPH, MS, chief, Division of Epidemiology, professor of preventive medicine, University of Tennessee Health Science Center, discusses ways to overcome racial disparity in prostate cancer.

Data presented at the 2018 ASCO Annual Meeting suggested that African American patients have a higher rate of mortality from prostate cancer compared with Caucasian patients. Fowke says these higher rates are probably largely due to disparity in the access to treatment. The only way to address the issue, is to change the way the healthcare system works in terms of insurance coverage, he adds.

While treatment access correlates with disparity in mortality, it does not affect prostate cancer risk. Researchers need to better understand the biology of prostate cancer—specifically differences in genomics between African American and Caucasian patients&mdash;but this is going to take time. In the long run, this will be beneficial to all patients and help to create a more personalized treatment approach, Fowke concludes.

Jay H. Fowke, PhD, MPH, MS

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