Prostate cancer, race and the need for tests
Following the article published about Sir Steve McQueen and his journey with prostate cancer ('My father's death saved my life': director Steve McQueen on grief, gratitude and getting cancer, 5 April, we were disappointed to read the response by Tanimola Martins (Letters, 11 April), which fails to acknowledge health inequalities faced by Black men and ethnic minorities in the UK.
Acknowledging that PSA (prostate-specific antigen) levels can be slightly higher in Black men, it still remains a useful screening test, especially if combined with MRI. What is not in doubt is that Black men are two to three times more likely to be diagnosed with prostate cancer than white men, and twice as likely to die from it. Add a family history of significant prostate cancer and the odds become even worse, bringing diagnosis to one in two and a risk likely greater than one in six with both risk factors, if untreated.
These figures have not changed for more than 10 years in the UK. Countering these stark statistics by quoting a single study showing Black British men are less likely to present with advanced disease does not detract from the fact that a family history and African or Caribbean heritage are primary risk factors for significant prostate cancer.
Prostate Cancer UK highlights the critical role of race in the fight against prostate cancer, stating that racial factors are not only significant in understanding disease prevalence but are central to addressing broader health inequities.
Therefore, our message is clear and simple: if you are a Black man and/or if you have a family history of prostate cancer – get tested sooner rather than later. Ignoring racial risk factors only sustains Eurocentric blind spots in research, policy and care failing those most at risk.
The testing of men in higher risk groups has the full support of the major prostate cancer charities and national urological organisations. The time to highlight this is now, and strive to provide more equitable and accessible care. Suks Minhas Professor of urology, Imperial College, London, Ben Challacombe Associate professor, urologist and prostate surgeon, Guy's and St Thomas' Hospitals, London and the UCLH, Guy's and St Thomas' and South Bank University diversity research collaborative
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