TABLE 2-3 Age-Standardized Incidence and Death Ratesa for Prostate Cancer by Race and Ethnicity, U.S., 1997 to 2001

Race/Ethnicity

Incidence

Mortality

White

167.4

28.8

African American

271.3

70.4

Asian/Pacific Islander

100.7

13.0

American Indian/Alaskan Native

51.2

20.2

Hispanic/Latinob

140.0

23.5

aRates are per 100,000 and age-adjusted to the 2000 U.S. standard population.

bHispanics/Latinos are not mutually exclusive from whites and other groups shown.

SOURCE: ACS (2005a).

from clinical trials may be available by 2008 (Brenner and Arndt, 2005). According to recommendations, men at average or high risk should be given information about the benefits and limitations of testing so they can make informed decisions about testing. Men diagnosed with prostate cancer tend to be better educated, in part because they are more likely to use (and be aware of recommendations for) PSA screening (Steenland et al., 2004).

Prostate cancer death rates declined an average of 4.1 percent per year from 1994 to 2001 (Jemal et al., 2004) (Figure 2-24). The majority of men diagnosed with prostate cancer in the PSA screening era do not have excess mortality compared to the general population under current patterns of medical care (Wilding and Remington, 2005; Brenner and Arndt, 2005). This finding does not suggest that PSA screening is either beneficial or ineffective, but it is reassuring information that can be provided to individuals recently diagnosed with prostate cancer.

With an estimated 30,350 deaths in 2005, prostate cancer is the second leading cause of cancer death in men (after lung cancer) (ACS, 2005a). Although death rates have been declining among white and African-American men since the early 1990s, rates in African-American men remain more than twice as high as rates in white men (Table 2-3). It is unclear what accounts for the marked racial differences in incidence and mortality among men with prostate cancer, but explanations include differences in biological and environmental factors, disparities in treatment, or combinations of these factors (Moul et al., 1996; Horner, 1998; Hsing and Devesa, 2001; Hsieh and Albertsen, 2003). Prostate cancer occurs at



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