Cancer screening status in Korea, 2011: results from the Korean National Cancer Screening Survey

This study was conducted to determine the use of screening for stomach, liver, colorectal, breast, and cervical cancers, which are included in the Korean National Cancer Screening Programme. In 2011 the National Cancer Centre in Korea conducted a nationwide, population-based, cross-sectional interview survey using multi-stage random sampling. Participants included 4,100 cancer-free men 40 years and over of age and women over 30 years of age. The lifetime screening rates for stomach, liver, colorectal, breast, and cervical cancers were 76.2%, 54.3%, 56.1%, 79.0%, and, 74.8%, respectively. The rates of recommended screening for stomach, liver, colorectal, breast, and cervical cancers were 64.6%, 22.9%, 35.3%, 60.4%, and 62.4%, respectively. More than 70% of all screening was attributed to organised cancer screening programmes. The main reason given for non attendance was 'no symptoms'. A greater effort is needed to increase screening rates, especially for liver and colorectal cancers.     

Breast Cancer Screening Disparity among Korean American Immigrant Women in Midwest

Purpose: Using three breast cancer screening methods such as mammogram, Clinical Breast Examination (CBE), and Breast Self-Examination (BSE), this study investigated breast cancer screening rates and its associated factors in Korean American immigrant women. Method: Cross-sectional data were obtained from 168 Korean immigrant women aged 40 and older in Midwest. The Andersen’s Behavioral Model (1995) theoretically guided this study and logistic regression was used to examine factors associated with screening receipt and performance. Results: Study participants reported low screening rates, specifically mammography and CBE uptake. About 71% of the women had a mammography at least once in their lifetime, while about 36% indicating receipt of a mammogram in the last three years. About 59% of the women received a CBE at least once in their lifetime, while about 32% had CBE in the past three years. About 74% of study participants have performed BSE at least once in their life time, while about 69% have done it in the past three years. Knowledge of screening method was consistently correlated with participant’s three breast cancer screening uptake. Additional factors that were positively associated with screening included older age, low barriers to mammograms, and lower educational attainment. Conclusions: Overall, study participants reported low rates of breast cancer screening receipt and performance. It is required to promote screening uptake among Korean immigrant women, especially women with young age, a lower level of education, and lack of health accessibility. A community-based language-appropriate health education program should be developed to increase health care access.     

Cancer screening in Korea, 2010: results from the Korean National Cancer Screening Survey

To investigate the participation rates in gastric, liver, colorectal, breast, and cervical cancer screening in Korea, including both organised and opportunistic programmes, a nationwide interview survey using multi-stage random sampling was conducted in 2010. A total of 4,056 cancer-free men aged over 40 years and women aged 30 years participated. Lifetime screening rates ranged from 54.2% (liver cancer) to 79.5% (breast cancer) and rates of screening in accordance with guidelines ranged from 22.9% (liver cancer) to 65.1% (gastric cancer). Upper endoscopy was the preferred method for gastric cancer, whereas the faecal occult blood test was conducted most often for colorectal cancer. The main reason stated for non attendance was 'no symptoms'. To increase attendance at cancer-screening programmes, efforts to increase education and accessibility of screening programmes are necessary.     

2014—2017年广西城市癌症早诊早治项目癌症风险评估及筛查结果分析

目的 分析 2014—2017 年广西城市癌症早诊早治项目中癌症高危评估和临床筛查结果。 方法 采用整群抽样的方法选取2014年11月至2017年8月广西南宁市西乡塘区和青秀区的40~74岁常住户籍人口为调查对象，以《防癌风险评估问卷》对其进行调查，评估出五大癌症（肺癌、上消化道癌、肝癌、结直肠癌和乳腺癌）高危人群并进行临床筛查，分析各癌种的高风险率、筛查参与率和检出率。结果 共152 630人完成问卷调查和风险评估，癌症高危72 376人（47.62%），其中肺癌、食管癌、胃癌、肝癌、结直肠癌和女性乳腺癌评估的高风险率分别为25.66%、17.39%、26.11%、28.95%、22.19%、32.76%；男性肺癌高风险率高于女性，女性食管癌、胃癌、肝癌、结直肠癌高风险率高于男性。肺癌、乳腺癌、肝癌、结直肠癌、上消化道癌的临床筛查参与率依次为26.42%、25.18%、25.03%、11.31%、7.68%。临床筛查结果显示，疑似肺癌、疑似肝癌、乳腺BI-RADS 4～5级、结直肠癌和上消化道癌的检出率分别为0.58%、0.05%、2.79%、0.13%和0.12%。结论 2014—2017年广西城市癌症早诊早治项目癌症筛查参与率及各癌种阳性病变检出率均不高，需提高区域人群防癌意识和体检筛查参与度，进一步识别癌症高危人群，提高筛查效果。     

Obesity and Screening Compliance for Breast and Cervical Cancer in Korean Women

Purpose : This study was performed to assess whether the weight status is associated with screeningrates of breast and cervical cancer in Korean women. Methods: Study participants included women agedbetween 30 and 80 years from the 4th Korea National Health and Nutrition Examination Survey from 2007to 2009. Body mass index was classified into ~18.4 kg/m2 (underweight), 18.5~22.9 kg/m2 (normal), 23~24.9kg/m2 (overweight), 25.0~29.9 kg/m2 (moderate obesity) and 30.0 kg/m2~ (severe obesity) according to theAsia Pacific Standards of WHO recommended definition of obesity. Screening rates of breast and cervicalcancer were estimated by the recommendation of the National Cancer Screening Program of the NationalCancer Center, Korea. Results : The overall screening rates for breast and cervical cancer were 51.3% and50.1%, respectively. After covariate adjustment, the screening rates for breast cancer (adjusted odds ratio,0.70; 95% confidence interval, 0.51 to 0.97) and cervical cancer (adjusted odds ratio, 0.71; 95% confidenceinterval, 0.53 to 0.94) were significantly lower in the women with severe obesity. Conclusion: Obesity isassociated with lower compliance with breast and cervical cancer screening guidelines in Korean women.     

Factors associated with attending the National Cancer Screening Program for liver cancer in Korea

Background and Aims: The National Cancer Screening Program (NCSP) for liver cancer was initiated in 2003 in Korea. The objective of this study was to evaluate the participation rate of the program and to provide preliminary information on its results based on data collected by the NCSP in 2009. Methods: The target population of the NCSP for liver cancer in 2009 was comprised of 373,590 adults aged ≥40 years at high risk for liver cancer. Participation rates and positivity rates were assessed in this population. Multivariate logistic regression analysis was performed to determine the factors associated with participation in the NCSP for liver cancer. Results: The overall participation rate was 37.9% and 1,126 participants were positive at screening. The highest participation rates were observed in women, those in their 60s, National Health Insurance beneficiaries, and individuals positive for hepatitis B surface antigen. Positivity rates for men, those in their 70s, Medical Aid Program recipients and individuals with liver cirrhosis were the highest in the respective categories of gender, age, health insurance type, and risk factor for liver cancer. Conclusions: The participation rates of the NCSP for liver cancer are still low, despite the fact that the program targets a high-risk group much smaller than the general population. Efforts to facilitate participation and to reduce disparities in liver cancer screening among Korean men and women are needed. These results provide essential data for evidence-based strategies for liver cancer control in Korea.     

Cancer Screening,Reproductive History,Socioeconomic Status,and Anticipated Cancer-related Behavior among Hmong Adults

In the United States, breast, cervical, colorectal and prostate cancer screening rates are low or non-existent in the ‍Hmong population compared to non-Hispanic Whites. No Hmong adults report ever participating in prostate (male ‍only) and colorectal cancer screening. US-born Hmong women, those living in the US ≥20 years, and those ≤39 years ‍old are more likely to be screened for breast and cervical cancer than other women. The Hmong, in general, are a ‍young population (median age = 34 years) with low socioeconomic status. As a function of these characteristics, 52% ‍of Hmong women reported having their first child at 15-19 years old and continued to bear children until 40-54 ‍years old. The combination of young age at first pregnancy and multiparity probably protects Hmong women from ‍breast cancer but elevates cervical cancer risk.     

2017—2019年深圳市宝安区40~74岁常住居民五癌风险流行状况分析

目的 分析深圳市宝安区常住居民“五癌”(肺癌、肝癌、上消化道癌、结直肠癌和乳腺癌)高危人群流行状况,更好地开展高危人群的早期预防、早期诊断和早期治疗工作。方法 利用高危人群风险评估模型(由国家癌症中心提供),问卷评估初筛五癌的高危人群,高危人群进一步临床检查。结果 2017—2019年共计完成问卷高危评估6072例,总体癌症高危率为55.55%,肺癌、肝癌、上消化道癌、结直肠癌和女性乳腺癌高危率分别为13.87%、19.60%、25.76%、15.27%和29.77%。单癌种、两癌种、三癌种、四癌种和五癌种高危率分别为31.35%、15.47%、6.19%、2.08%和0.56%。肺癌、肝癌、上消化道癌和结直肠癌高危率均为男性高于女性,差异存在统计学意义(P＜0.05)。肺癌、上消化道癌和结直肠癌在50~69岁年龄段人群高危率较高,肝癌和女性乳腺癌在40~69岁年龄段人群高危率较高,尤其是在40~49岁年龄段最高,总体差异均存在统计学意义(P＜0.01)。疑似肺癌检出率3.16%,肝脏占位阳性率为22.45%,上消化道息肉阳性率为22.09%,大肠癌检出率为0.33%,乳腺BI-RADS3级和BI-RADS4级检出率分别为17.62%和0.82%。结论 此分析初步揭示了深圳宝安区的5类癌症的人群高危风险率,阐明了临床筛查依从性和检出率等指标,为进一步优化人群癌症筛查和早诊早治工作提供理论参考。     

Fluctuating Behavior of the French Population in Cancer Screening: 5th Edition of the EDIFICE Survey

Background

The EDIFICE surveys have assessed cancer screening behavior in the French population since 2005.

Methods

The 2016 edition was conducted among a representative sample of 1501 individuals (age, 50–75 years). The current analysis focuses on breast, colorectal, prostate, lung, and cervical cancer screening.

Results

The rate of women (50 to 74 years) declaring having had at least one breast cancer screening test in their lifetime remained stable and high between 2005 and 2016. Compliance with recommended screening intervals improved between 2005 and 2011 from 75 to 83%, respectively, then decreased significantly to 75% in 2016 (P?=?0.02). Uptake of at least one lifetime colorectal cancer screening test procedure declared (individuals aged 50–74 years) increase from 25% in 2005 to 59% in 2011, stabilized at 60% in 2014, then reached 64% in 2016. Opportunistic prostate cancer screening (men aged 50–75 years) rose between 2005 and 2008 from 36 to 49%, plateaued until 2014 then dropped to 42% in 2016. The proportion of women aged 50–65 declaring having undergone one cervical cancer screening test dropped significantly between 2014 and 2016 from 99 to 94% (P?<?0.01). Lastly, 11% of our survey population in 2014 and 2016 (55–74 years) declared having already undergone lung cancer screening.

Conclusion

Cancer screening behavior fluctuates in France, regardless of the context, i.e., organized programs or opportunistic screening. This observation highlights the need for constant analysis of population attitudes to optimize public awareness campaigns.

     

依托妇幼卫生服务体系建立乳腺癌筛查机制

目的探讨妇幼卫生服务网络在乳腺癌筛查中的作用。方法采取随机整群抽样的方法,在武汉市中心城区抽取35~59岁妇女33 019名为研究对象,利用妇幼卫生服务网络对筛查工作进行组织管理,采用乳腺临床体检、钼靶X线摄片和彩超检查相结合的筛查方案,所有病变诊断及转归的判定均以组织病理学检查为依据。计算筛查率、复查率和乳腺癌检出率等指标,评价妇幼卫生服务体系对乳腺癌筛查的作用。结果33 019名妇女中,30 478名妇女参与了乳腺癌筛查,筛查率为92.30%;钼靶或彩超的复查率为92.47%。通过临床检查、钼靶和彩超联合检查的乳腺癌或可疑癌患者均接受手术治疗,最终25人确诊为乳腺癌,乳腺癌检出率为82.03/100 000。结论利用妇幼卫生服务网络组织乳腺癌筛查,提高了人群顺应性,技术力量能够得到整合,大大提高乳腺癌筛查的质量。     

Cancer in the very elderly Dutch population

BACKGROUND: Cancer incidence and mortality rates rarely are studied in people age > 85 years. Usually, patients ages 65 years, 75 years, and 85 years of age are combined into 1 group because of small numbers. The number of people age > or = 85 years in the Netherlands increased from 99,000 in 1976 to 203,000 in 1995 (an increase of 105%). The growth of the total population in this period was only 13%. This study addressed cancer incidence and mortality rates among the very elderly in the Netherlands. METHODS: Cancer mortality data (1976-1995) and population data were obtained from Statistics Netherlands, whereas cancer incidence data (1989-1995) were provided by the Netherlands Cancer Registry. Cancer incidence and mortality rates were calculated and trends in cancer mortality were studied. RESULTS: Total cancer incidence rates were highest in the age group 85-94 years, in men and women (3466/100,000 person-years and 1604/100,000 person-years, respectively). Prostate carcinoma was the most frequent cancer in men ages 85-94 years, followed by colorectal carcinoma. In women ages 85-94 years, colorectal carcinoma was most frequent, closely followed by breast carcinoma. In the 95+ years age group squamous cell skin carcinoma was the most frequent cancer in both men and women, followed by prostate carcinoma in men and breast carcinoma in women. Cancer mortality rates increased with increasing age to nearly 3700/100,000 person-years in men age 95+ years and 2500/100,000 person-years in women age 95+ years. In men, lung carcinoma was the most frequent cancer-related cause of death in patients age < or = 85 years, whereas in older men this applied to prostate carcinoma. In women, breast carcinoma was the most frequent cancer-related cause of death in all age groups > 55 years. Cancer as a cause of death became less prominent with increasing age. Over the period 1991-1995, 42% of deaths in men ages 55-64 years were attributed to cancer versus 52% of deaths in women (total population); these proportions in the 95+ years age group were 11% and 7%, respectively. CONCLUSIONS: Peak incidence rates of major cancers were found in the very elderly population in the Netherlands. Different trends in age specific mortality rates of individual cancer sites were found, with stable rates in the middle age groups and increasing rates in the oldest age groups. This may reflect a real increase caused for instance by changes in mortality from other diseases and/or an artifactual increase caused by increased cancer detection rates in the (very) elderly.     

Colorectal Cancer Screening among Asian Americans

Objectives: Colorectal cancer (CRC) is the most commonly diagnosed cancer for all US populations includingAsian Americans. CRC screening has considerable benefits to prevent CRC and reduce mortality. The purposeof this article was to review the published literature on rates of colorectal cancer screening and factors associatedwith colorectal cancer screening practice among Asian Americans. Methods: Through searching electronicreference databases from 2000 to 2013, 30 articles were found on Chinese, Filipino, Japanese, Korean, andVietnamese Americans. Findings: Asian Americans had significantly low ratesfor CRC screening; KoreanAmericans reported the lowest rates, while higher screening rates were found among Japanese Americans.Older age, longer length of stay in the US, and having a physician’s recommendation were the most commonfacilitators to receiving screening. The common inhibiting factors were financial issues, employment status,and worries/fears about the procedure. Conclusions: Despite a number of Asian Americans being vulnerableto CRC, individual Asian subgroups were underserved with CRC screening and intervention. Further studiesshould focus on each individual Asian subgroup and culturally proficient CRC screening intervention programsshould be developed for each.     

Understanding Breast Cancer Screening Practices in Taiwan: a Country with Universal Health Care

While the incidence of breast cancer (BC) has been relatively low in Asian countries, it has been rising rapidlyin Taiwan. Within the last decade, it has replaced cervical cancer as the most diagnosed cancer site for women.Nevertheless, there is a paucity of studies reporting the attitudes and practices of breast cancer screening amongChinese women. The aim of this study is to assess Taiwanese women’s knowledge of and attitudes toward BCscreening and to identify potential factors the may influence screening behavior. The study population consistedof a sample of 434 Taiwanese women aged 40 and older. Despite access to universal health care for Taiwanesewomen and the fact that a majority of the women had heard of the breast cancer screening (mammogram, clinicalbreast exams, etc.), the actual utilization of these screening modalities was relatively low. In the current study, themajority of women had never had mammograms or ultrasound in the past 5 years. The number one most reportedbarriers were “no time,” “forgetfulness,” “too cumbersome,” and “laziness,” followed by the perception of noneed to get screened. In addition, the results revealed several areas of misconceptions or incorrect informationperceived by study participants. Based on the results from the regression analysis, significant predictors ofobtaining repeated screening modalities included age, coverage for screening, barriers, self-efficacy, intention,family/friends diagnosed with breast cancer. The findings from the current study provide the potential to buildevidence-based programs to effectively plan and implement policies in order to raise awareness in breast cancerand promote BC screening in order to optimize health outcomes for women affected by this disease.     

Breast and colorectal cancer screening among low-income women with psychiatric disorders

This study investigated breast and colorectal cancer screening among 196 low-income women being treated for psychiatric illnesses. Main outcome measures included breast self-examination (BSE), clinical breast examination (CBE), mammography, digital rectal examination (DRE), and fecal occult blood test (FOBT). Results indicated that 49% and 66% of women 40 years of age or older had obtained mammograms and CBEs, respectively, in the preceding year. Forty-four per cent of women 20 years of age or older reported monthly BSE. Forty-six per cent and 35% of women 50 years of age or older reported having digital rectal exams (DRE) or fecal occult blood tests (FOBT), respectively, in the preceding year. Multivariate analyses showed that physician recommendation of screening was the strongest predictor of having obtained a mammogram, CBE, DRE or FOBT in the preceding year. Physician recommendation and self-confidence in performing BSE were the strongest predictors of monthly BSE. These results highlight the importance of physician recommendation of adherence to screening guidelines for breast and colorectal cancer. Because psychiatrists frequently treat psychiatric patients on a regular basis, they are in a unique position to encourage cancer screening and to monitor compliance with their recommendations.     

Mammography Screening and Breast Cancer Mortality in New South Wales, Australia

OBJECTIVE: To investigate the relationship between utilisation of service mammography screening and breast cancer mortality in New South Wales (NSW) women. Setting : Population-based biennial mammography screening was progressively introduced in NSW from 1988, with active recruitment and re-invitation for women aged 50-69 years, and reached full geographic coverage by 1996. Biennial mammography screening participation has varied widely over time and by municipality. METHODS: Breast cancer mortality by age, period and municipality was obtained from the NSW Central Cancer Registry. Biennial mammography screening rates for the same strata were obtained from the BreastScreen NSW database. Temporal changes in breast cancer mortality for NSW were summarised as annual average declines using Poisson regression. Breast cancer mortality for 1997-2001 was examined in relation to lagged biennial screening rates by municipality, adjusted for age, area socio-economic and geographic indicators, and breast cancer incidence, also using Poisson regression. RESULTS: For the 50-69 year age group, the mean annual breast cancer mortality decline was 0.8% (not significant) for 1988-1994, and 4.4% (p < 0.0001) for 1995-2001. Statistically significant negative associations between breast cancer mortality in 1997-2001 and lagged biennial screening rates were found with the highest significance at a four-year lag for women aged 50-69 years ( p = 0.0003) and also for women aged 50-79 years (p c = 0.0002). From the regression coefficient, a 70% biennial screening rate is associated with 32% lower breast cancer mortality (compared to zero screening). CONCLUSIONS: The effect of population-based mammography screening on breast cancer mortality in NSW inferred using this method is consistent with results of trials and other service studies. This suggests that population-based mammography screening programs can achieve significant reductions in breast cancer mortality with adequate participation.     

Colorectal Cancer Screening Practices of Primary Care Providers: Results of a National Survey in Malaysia

The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia duringthe past few decades. A physician recommendation has been shown to be a major factor that motivates patientsto undergo screening. The present study objectives were to describe the practice of colorectal cancer screeningby primary care providers in Malaysia and to determine the barriers for not following recommendations. Inthis cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia,self-administered questionnaires which consisted of demographic data, qualification, background on the primarycare clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed.A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommendedfaecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrierwas “unavailability of the test”. The two most common patient factors are “patient in a hurry” and “poor patientawareness”. This study indicates that colorectal cancer preventive activities among primary care providers arestill poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poorawareness and understanding of the importance of colorectal cancer screening among patients. More awarenessprogrammes are required for the public. In addition, primary care providers should be kept abreast with thelatest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.     

Awareness of Cancer and Cancer Screening by Korean Community Residents

The purpose of this study was through a survey of awareness of cancer and cancer screening of Korean community residents to identify the stereotypes of cancer and bases for development of improved screening programs for early detection. Subjects were residing in South Korea Gangwon-Province and were over 30 years and under 69 years old. The total was 2,700 persons which underwent structured telephone survey questionnaires considered with specific rates of gender, region, and age. For statistical analysis, PASW Statistics 17.0 WIN was utilized. Frequency analysis, the Chi-square (X2) test for univariate analysis, and logistic regression analysis were performed. The awareness of cancer and cancer screening in subjects differed by gender, region and age. For the idea of cancer, women thought about death less than men (OR: 0.73, p<0.001). On the other hand, women had negative thoughts - fear/terror/suffering/pain/pain - more than their male counterparts (OR: 2.04, p<0.001). Next, for the idea of cancer screening, women recognized fear/terror more than men (OR: 1.38, p<0.01). Thehigher age, the more tension/anxiety/worry/burden/irritated/pressure (OR: 1.43, p<0.01, OR: 2.15, p<0.001, OR: 2.49, p<0.001)). People may be reminded of fear and death for cancer and of fear, terror, tension and anxiety for cancer screening. To change vague fear and negative attitudes of cancer could increase the rate of cancer screening as well as help to improve the quality of life for community cancer survivors and facilitate return to normal social life. Therefore, it is necessary to provide promotion and education to improve the awareness ofcancer and cancer screening.     

Women's Breast Cancer Risk Perception and Attitudes Toward Screening Tests

This study's objective is to identify women's breast cancer risk perceptions and their attitudes and knowledge on screening tests. The cross-sectional research. Gulhane Military Medical Academy, Ankara, Turkey. The population of 188 females who applied for gynecological examination. The study employed a semistructured questionnaire form. Questions such as female's demographic data, attitudes based on screening tests of breast cancer, family history, perceived risk breast cancer, and questions with regard to patients’ fear of breast cancer were included in the survey. In this study, it is determined that the rates of the women, who conduct breast self-examination (BSE), clinical breast examination (CBE) and mammography at least once, are very low. The reason for not performing the BSE was declared with a rate of 50.8% as “Do not know how to perform.” Of the women 20.2% were fully acknowledged about BSE. Nearly half of the women perceived 50% or more risk of developing breast cancer, and this rate increases as they get older. The risk perception and educational status increased CBE and mammography rates and BSE knowledge positively, but because of insufficient BSE application abilities BSE rate cannot increase as expected. It is recommended that nurses put forward the initiatives in training programs to increase women's BSE abilities. In planning such an education program risk perception and information of women about breast cancer should be considered.     

Trends in Distant-Stage Breast, Colorectal, and Prostate Cancer Incidence Rates from 1992 to 2004: Potential Influences of Screening and Hormonal Factors

Differential utilization of cancer screening between populations could lead to changes in cancer disparities. Evaluating incidence rates trends is one means of monitoring these disparities. Using Surveillance, Epidemiology, and End Results data, we compared annual percent changes (APC) in age-adjusted incidence rates of distant-stage breast, colorectal, and prostate cancer between non-Hispanic whites (NHW) and African Americans (AA). From 1992 to 2004, distant-stage breast cancer incidence rates remained essentially constant among both AA and NHW women, though rates were 30–90% higher among AA women throughout. NHW men and women experienced declines in distant-stage colorectal cancer incidence rates [APC?=??1.6, 95% confidence interval (CI) ?2.3, ?0.9], but AA men and women did not. Distant-stage prostate cancer incidence rates declined for both AA (APC?=??5.8, 95% CI ?7.9, ?3.8) and NHW (APC?=??5.1, 95% CI ?6.7, -3.4). Despite now having nearly equal mammography screening rates, the persistent breast cancer disparity observed among AAs compared to NHWs may be due to the greater susceptibility of AAs to more aggressive tumors, particularly hormone-receptor-negative disease, which is more difficult to detect by mammography. For colorectal cancer, greater utilization of screening tests among NHWs vs. AAs is likely a primary contributor to the observed widening disparity. Wider recognition of AA race as a prostate cancer risk factor may contribute to the narrowing disparity in the incidence of disease.