Dear Editor,

Every year, September is celebrated internationally as prostate cancer awareness month. But I wonder just how aware we are in Jamaica about the severity of this disease. It is no secret that prostate cancer is the commonest cancer in Jamaican men, and has been so for several decades. It represents 36.5 per cent of all male cancers in Jamaica. In addition, it represents the leading cause of male cancer deaths in Jamaica. Debatably, Jamaica has one of the highest rates of prostate cancer in the world.

There are racial disparities in the incidence if prostate cancer. Black men are more at risk. Hence data from Sub-Saharan Africa and many Caribbean nations reveals that prostate cancer is the commonest male cancer. In the United States, prostate cancer is almost twice more common in black men than Caucasian men. The disease presents at a younger age, more advanced clinical stage and with more aggressive pathological features in black men. The result is a higher death rate from the disease in black men.

With these alarming statistics in mind, most international urological organisations or cancer associations consider black men high-risk and have recommended screening for prostate cancer. The Jamaica Urological Society also recommends annual screening for prostate cancer, starting at age 40. The JUS partners with the Jamaica Cancer Society in providing screening clinics and public information campaigns, in an effort to fight prostate cancer. Despite these efforts, the progress is slow. The Jamaica Cancer Society provides screening clinics for breast, cervical and prostate cancer. In 2009, fewer than 500 men presented for prostate cancer screening at the JCS clinics, compared to approximately 20,000 women for their screening clinic. Local data from the Urology Division at the University of the West Indies suggests that many cases of prostate cancer are still being diagnosed at an advanced clinical stage. Yet, it is only through screening that the disease may be detected early and potentially cured.

So what accounts for the poor uptake of nationwide screening? This has been studied extensively in African-American men. We share similar issues. Some of these include fear of the diagnosis, low socio-economic status and access to screening, mistrust of the health-care system, fear of the digital rectal exam (DRE) used in screening and fear of the potential side-effects of treatment. Screening for prostate cancer is done by conducting a DRE and blood test called prostate specific antigen (PSA) annually.

Screening can be carried out by any doctor at any level of the health-care sector and therefore screening is available to all Jamaicans. The DRE is a quick, simple and painless physical exam. It is only through public campaigns that we can educate men about their misconceptions and the barriers to effective screening. This requires not only the effort of the JUS, JCS and Ministry of Health, but also a collaborative effort of all civic groups and individual Jamaicans. We should aim for this Prostate Cancer Awareness Month to truly increase the knowledge of the population about this epidemic facing our Jamaican men whom we love.

Dr Belinda F Morrison

Consultant Urologist

University Hospital of the West Indies

Kingston 7