Prostate-specific antigen levels in African-Americans correlate with insurance status as an indicator of socioeconomic status.

Abstract

Our results suggest that socioeconomic differences are responsible for the racial differences noted in prostate cancer. Our findings of higher PSA levels in African-American Medicare-only patients may result from the many African-Americans disproportionately uninsured throughout their lives compared with whites and thus using services at later stages of disease. A second possible explanation is cultural or ethnic differences in care-seeking behavior, with poorer African-Americans less likely to pursue care for disease until it has progressed. Our findings can explain the dichotomy of poorer overall outcome among African-Americans with prostate cancer, but comparable stage-adjusted outcome with comparable treatments between African-Americans and whites.