Wealthy men survive prostate cancer

Wealthy men with prostate cancer may receive better care than poor men with the disease and may live longer as a result, a new study hints.

In the study conducted in Geneva, Switzerland, researchers found that prostate cancer patients with lower incomes were more likely to die than their counterparts with higher incomes.

Several prior studies on "socioeconomic status" and death from prostate cancer have been conducted in North America, particularly the United States, Dr. Elisabetta Rapiti of the University of Geneva and her colleagues note in the journal Cancer.

They wanted to know how disparities affected prostate cancer deaths in Switzerland, a country with a well developed health care system and where healthcare costs, medical coverage, and life expectancy are among the highest in the world, they explain.

How the study was done
The researchers studied 2,738 men from Geneva who were diagnosed with prostate cancer between 1995 and 2005. The men were classified as having high, medium, or low socioeconomic status on the basis of their occupation at the time of diagnosis.

Compared with men of high socioeconomic status, those of low socioeconomic status were less likely to have their cancer detected by screening, had more advanced cancer at diagnosis, and had fewer tests to characterize their cancer, Rapiti and colleagues found.

Men with low socioeconomic status were also less apt to have their prostates removed and were more apt to be managed with careful monitoring -- what doctors call "watchful waiting."

Men with low socioeconomic status also had a 2-fold increased risk of dying from prostate cancer compared with men of high socioeconomic status. "The increased mortality risk of patients of low socioeconomic status is almost completely explained by delayed diagnosis, poor work-up, and less complete treatment, indicating inequitable use of the health care system," Rapiti noted in prepared statement.

"Policies ensuring a more equitable access to screening and treatment are needed to eliminate these disparities," the investigators conclude. – (Reuters Health, October 2009)

SOURCE: Cancer, online September 28, 2009.

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