PMID: 9166537Jul 1, 1996Paper

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

The Cancer Journal From Scientific American
S VijayakumarS Hellman

Abstract

African-Americans have a higher age-adjusted incidence and a higher disease-specific mortality than whites. Two potential causes are differences in biology or socioeconomic status, the latter leading to differences in access, delivery, or utilization of health care. In this study, we compare serum prostate-specific antigen (PSA) levels for comparable stage and grade-disease, as well as individual insurance status. PSA is a demonstrated indicator of the size and virulence of tumor and is correlated with prognosis. Insurance status has been linked with income and education and is an indicator of access to medical care. All patients were referred to the University of Chicago Center for Radiation Therapy (UCCRT) with stages A-C (T1-4) prostate cancer. They were seen in four different facilities, designated A through D, and were evaluated and staged by the faculty of UCCRT using the same criteria. Hospitals A and B are large teaching hospitals located within the city of Chicago; C and D are suburban and urban community hospitals, respectively. A total of 341 patients seen between May 1987 to November 1992 are included in this study. In univariate analysis, PSA levels were significantly associated with stage, grade, and race. Higher ...Continue Reading

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