Eamonn Rogers
Chair of the Patient Office
Black men often receive a prostate cancer diagnosis later. Building trust, improving communication and training clinicians in culturally inclusive care could help close the gap.
Black men face more than twice the risk of prostate cancer diagnosis and death compared to White men. Yet, despite this stark difference, Black men are often diagnosed later, limiting their treatment options and survival chances.
More than genetics
While biology may partly explain these differences — for example, Black men tend to develop more aggressive prostate cancers and, on average, have slightly higher prostate-specific antigen (PSA) levels — these factors alone do not account for the unequal outcomes. A significant and often overlooked barrier lies in the relationship between healthcare providers and Black patients. Mistrust of the healthcare system, shaped by past negative experiences and systemic inequities, discourages many Black men from seeking early screening or openly discussing prostate health.
Representation and inclusion
To improve prostate cancer care, the ability of healthcare professionals (HCPs) to understand and respect cultural differences must be a priority. This is often referred to as ‘cultural competence’ — meaning the skills and awareness needed to communicate effectively and respectfully with patients from diverse backgrounds. In practice, this involves inclusive communication, active listening and shared decision-making (SDM) that values each patient’s perspective.
Healthcare systems must prioritise practical training in communication
skills, shared decision-making and address unconscious bias
Training clinicians for inclusive care
HCPs of all cultural backgrounds can benefit from culturally responsive practices that foster trust and support informed patient choice. Building this trust goes beyond clinical expertise; it requires clear, respectful communication that acknowledges patients’ backgrounds, experiences and concerns.
However, some clinicians still struggle to meet these levels of understanding. Healthcare systems must prioritise practical training in communication skills, shared decision-making and address unconscious bias to close this divide. Ultimately, cultivating genuine trust through honest and empathetic dialogue is key to empowering Black men and improving survival outcomes.
The European Association of Urology (EAU) has been taking steps to address these challenges. One such initiative is the patient-reported outcome measures (PROMs) study BALANCE: Embracing Diversity in Prostate Cancer led by the EAU Patient Office, focusing on prostate cancer care for Black men of African and Caribbean descent.
Read more about the BALANCE Study here.
