BY PATRICIA ANSTETT
FREE PRESS MEDICAL WRITER
November 19, 2002
Tri-county Detroit and Michigan have catapulted to an unwanted distinction: More men here get prostate cancer than anywhere else in the nation except Washington, D.C., a new federal report says.
Prostate cancer occurs even more often among African-American men, says the report issued Monday by two federal agencies.
"This is another wake-up call," said Ray Demers, director of the Josephine Ford Cancer Center at Henry Ford Hospital in Detroit and a respected cancer statistician. "Now we have to figure out why there's such a racial disparity."
The report reflects a major improvement in how cancer cases are counted in the United States, said Tommy Thompson, U.S. Health and Human Services secretary, in releasing the 292-page report.
The report covers 37 states, six metropolitan areas and Washington D.C., reflecting cancer diagnosed among 78 percent of the U.S. population. It uses 1999 data, the latest available, gathered by the National Cancer Institute and the Centers for Disease Control and Prevention.
Data improvements stem from a 1994 law to help states upgrade cancer registries. Up to now, the government's cancer statistics have been much more limited, covering 14 percent of the population living in metro areas like Detroit, which has had a cancer registry since 1973.
Detroit-area cancer specialists say they have known all along that prostate cancer rates were high in the area. In the past, Michigan has ranked in the top four states for prostate cancer, according to Jamie Bearse, a spokesman for the National Prostate Cancer Coalition, a Washington, D.C.. advocacy group. Possible reasons include diets heavy in fats and red meat and a lack of awareness in the African-American community about the benefits of screening, he said.
"We need to educate more men to come in early," said Dr. Isaac Powell, a prostate cancer researcher and survivor at the Barbara Ann Karmanos Cancer Institute in Detroit, which houses one of the nation's oldest cancer registries.
The Detroit-area cancer registry records as much as 99 percent of all cancer diagnosed in Wayne, Oakland and Macomb counties. Other state registries, new to the task of counting cancer, don't do as good a job, Demers said.
The report also raises the issue of whether Detroit and Michigan's future cancer rates will look as bad once other states and metropolitan areas develop registries.
How high are the statistics for Michigan and tri-county Detroit?
For every 100,000 men living in Michigan in 1999, 202 got prostate cancer; in tri-county Detroit, 219 of every 100,000 men developed the disease.
Nationwide, 162 cases of prostate cancer were diagnosed among every 100,000 men.
Michigan and Detroit's numbers climb among African-American men, though not as high as in some other cities and states.
In tri-county Detroit, 299 black men of every 100,000 living in the area were diagnosed with prostate cancer in 1999.
Statewide, 290 cases of prostate cancer among black men were diagnosed for every 100,000 in the state.
Atlanta, which also has a large African-American population, ranks higher than Detroit for the incidence of prostate cancer among blacks, with 311 cases for every 100,000 black men.
Iowa and Maryland have a higher percentage of African Americans diagnosed with prostate cancer than Michigan, for reasons not entirely clear.
Studies show that only 9 percent of black men in Michigan, compared to 30 percent of white men in the state, get tested for prostate cancer, though those numbers are improving with educational programs, Powell said. He speaks throughout the city on the issue, even giving lectures from church pulpits on Sundays.
Powell said Detroit research has identified genetic changes more common in African-American men that signal the beginning of cancer, particularly more aggressive tumors.
Both Demers and Powell urged black men to be tested at age 40, and white men at age 50, or younger, if a man has a family history of prostate cancer.
Prostate cancer is the leading cause of male cancer in the United States, accounting for an estimated 200,000 cases this year, according to the American Cancer Society. Warning signs include weak or interrupted urine flow; inability to urinate; blood in the urine or pain on urination; and pain in the back, pelvis or thighs.
The full report is available on the Web at www.cdc.gov/cancer/npcr.
Contact PATRICIA ANSTETT at 313-222-5021 or anstett@freepress.com.
All content © copyright 2002 Detroit Free Press and may not be republished without permission.
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*Rates are age-adjusted to the 2000 U.S. standard population.
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