Study examines disparities in prostate cancer survival in Appalachian Kentucky

A new study by University of Kentucky Markey Cancer Center researchers shows a higher mortality rate for prostate cancer among men from Appalachian Kentucky compared to men from non-Appalachian Kentucky.

Published in Rural Remote Health, researchers used data from the Kentucky Cancer Registry to characterize the survival disparities of prostate cancer between Appalachian and non-Appalachian Kentucky. The study showed a significant difference in survival that was not related to geographic location, but to the aggressiveness of the disease.

Prostate cancer patients from Appalachia had a higher Gleason score (a grade that measures the aggressiveness of cancer), higher prostate specific antigen (PSA), more aggressive histologic grade, more distant disease and a high comorbidity score. Additionally, the Appalachian patients had lower levels of education and higher poverty.

When detected early, prostate cancer is usually treatable and curable. The U.S. Preventive Services Task Force recommends men ages 55-69 get periodic screenings for prostate cancer. Screening for prostate cancer begins with a PSA test, which measures the level of PSA in the blood. A higher PSA can be an indicator of cancer, although many other factors can cause PSA to be elevated. A doctor may recommend a biopsy to confirm the presence of cancer in patients with a high PSA.

Dr. Peng Wang, medical oncologist at the UK Markey Cancer Center, says the results show a need for increased awareness of prostate cancer screening and increased access to health care and education in the Appalachian region of the state.

"Not only should there be efforts to educate Appalachian Kentuckians at the individual patient and family levels, but interventions are also needed to train and empower healthcare systems, clinicians, and support teams to deliver quality care for prostate cancer," Wang said.