Cancer Survival Rate in Seattle Highest in World - unless you'reblack

according to Concord study published in The Lancet Oncology. As cancers
are overdiagnosed in the U.S. (i.e. low grade cancers that don't need to
be treated are also included) the U.S. five year survival rates are not
directly comparable to those of other countries.

http://tinyurl.com/6xwep5

On Jul 17, 5:33 am, safire <saf...@telenet.com> wrote:
> according to Concord study published in The Lancet Oncology. As cancers
> are overdiagnosed in the U.S. (i.e. low grade cancers that don't need to
> be treated are also included) the U.S. five year survival rates are not
> directly comparable to those of other countries.
>
> http://tinyurl.com/6xwep5

As Steve J. always says, we need to see the original study in
order to be sure about what it said.

It was once thought that black men had a greater genetic
predisposition to prostate cancer than white men. Now, as I
understand it, that theory is in doubt. It may just be that
black people, on average, have less access to advanced health
care (or any health care) than whites in the U.S. - which is a
well established fact.

As for survival rates, there are interesting issues there.

One measure of survival is, What percentage of men who are
diagnosed wind up dying of PCa? That measure is easily biased by
over diagnosis.

But another measure is, What percentage of the population dies of
PCa? Just take the size of the population and divide by the
number of PCa deaths. As far as I can see, that measure cannot
be biased by over diagnosis.

I believe that if you use that second measure, the U.S. comes
out way ahead of, for example, the U.K.

U.S. population = 300 million, PCa deaths = 25,000 [1]
U.K. population = 60 million, PCa deaths = 10,000 [2]

[1] http://www.seer.cancer.gov/faststats...?series=cancer
All ages and races for the year 2005.
It was 30,000 just five years before in 2000.

[2] http://www.who.int/whosis/mort/profi...tedkingdom.pdf
Taken from the World Health Organization report for the year
2002.


UK deaths rates were *twice* the U.S. rates.

That still doesn't tell us why. Some possible reasons could be:

1. U.S. cancer treatment is more effective.

2. U.K. men are more at risk due to some environmental factor.

3. U.K. men are more at risk due to some genetic predisposition.

4. U.K men are overall healthier, live longer, and are therefore
more likely to die of cancer, a disease of old age.

I suspect explanation number 1 is the most likely, but I have no
data to back up that suspicion. I suspect it because PSA testing
is not done routinely in the UK and patients are often not
diagnosed until they are metastatic and beyond curative
treatment. However, I can say that I'm not alone in having that
suspicion.

Alan

Alan Meyer wrote:
> It was once thought that black men had a greater genetic
> predisposition to prostate cancer than white men. Now, as I
> understand it, that theory is in doubt. It may just be that
> black people, on average, have less access to advanced health
> care (or any health care) than whites in the U.S. - which is a
> well established fact.
>

Alan,

You should check out the research done by Dr. Rick Kittles on this
subject. Basically, he found that much of the increase in prostate
cancer in black men is due to lower levels of Vitamin D. Basically, the
darker the skin the less Vitamin D that is converted by sunlight.
Prostate cancer seems to increase with increased darkness of the skin,
plus there is a higher incidence of prostate cancer the further away
from the equator you go.

He also has identified a number of genetic mutations originating from
areas of West Africa which increase the incidence of prostate cancer.
What is interesting is that while these mutations are mainly found in
some black men, they are also occasionally found in white men.

Ed Friedman

Ed Friedman wrote:
> Alan Meyer wrote:
>> It was once thought that black men had a greater genetic
>> predisposition to prostate cancer than white men. Now, as I
>> understand it, that theory is in doubt. It may just be that
>> black people, on average, have less access to advanced health
>> care (or any health care) than whites in the U.S. - which is a
>> well established fact.
>>
>
> Alan,
>
> You should check out the research done by Dr. Rick Kittles on this
> subject. Basically, he found that much of the increase in prostate
> cancer in black men is due to lower levels of Vitamin D. Basically, the
> darker the skin the less Vitamin D that is converted by sunlight.
> Prostate cancer seems to increase with increased darkness of the skin,
> plus there is a higher incidence of prostate cancer the further away
> from the equator you go.
>
> He also has identified a number of genetic mutations originating from
> areas of West Africa which increase the incidence of prostate cancer.
> What is interesting is that while these mutations are mainly found in
> some black men, they are also occasionally found in white men.
>
> Ed Friedman

Fascinating. So there really does appear to be a physiological
reason.

I will urge my black friends to get their PSA tested regularly.

Ed Friedman wrote:
....
> plus there is a higher incidence of prostate cancer the further away
> from the equator you go.
....

It is also noteworthy that the UK is further north than
the US. Conceivably, that is a factor in their higher
PCa rates. If so, we should see even higher rates in
Norway, Sweden and Finland.

Alan