In 511 counties in America, there aren’t any doctors who screen for or treat prostate cancer
Prostate cancer is the second most common cancer in the United States. 1 in 8 men will develop the disease in his lifetime, and more than 160,000 new cases are expected to be diagnosed this year. However, screening may not even be an option for many men across the country. While there is a heated debate over whether screening for prostate cancer does more harm than good, there are thousands of at-risk men across the country who lack access to both screenings and treatment.
Analyzing Amino's doctor database, we found that 511 counties in the United States have zero doctors who screen for or treat prostate cancer. 781,000 men age 50 and over live in these counties, which are scattered throughout the country, mostly in rural areas.
For this analysis, we isolated doctors in relevant specialties (urologists, internists, family practitioners, radiation oncologists, cardiologists, and hematologist oncologists) who conducted a prostate cancer screening or treated a patient for prostate cancer in the last three years. We used 2015 census data to determine that 781,000 men age 50+ live in the counties highlighted in orange.
Many areas with poor access to care have high risk populations
Beyond age, the biggest risk factor for prostate cancer is race and ethnicity.
It’s known that African American men are at higher risk of developing prostate cancer than any other population. Overall, African American men are 1.7 times more likely to be diagnosed with prostate cancer than white men—and 2.3 times more likely to die from it. A recent study found that black men are also less likely than their white counterparts to receive aggressive treatment.
We didn’t find any correlation between the density of prostate cancer doctors and the African American population in a given county. However, of the top 10 largest counties with zero doctors who screen for or treat prostate cancer, three have a population that’s 25% or more African American (highlighted below).
|10 largest counties with no doctors who screen for or treat prostate cancer|
|County||Total population||% African American|
|Waller County, Texas||45,847||25%|
|Caldwell County, Texas||39,347||7%|
|Benton County, Minnesota||39,221||2%|
|Hill County, Texas||34,923||7%|
|Chambers County, Alabama||34,079||40%|
|Lawrence County, Alabama||33,586||11%|
|Harris County, Georgia||32,776||16%|
|Lassen County, California||32,645||9%|
|Ottawa County, Oklahoma||32,085||1%|
|Caroline County, Virginia||29,349||29%|
All in all, of the 511 counties we identified with no prostate cancer screening or treatment doctors, 58 have a population that’s 25% or more African American, and 17 have a population that’s majority African American (more than 50%).
We didn’t find any correlation between our data and county-level prostate cancer mortality rates. But for the large populations of African American men who live in these counties and are at high risk of being diagnosed with and dying from prostate cancer, not having convenient access to care could be life-threatening. A recent study found that African American men diagnosed with early-stage prostate cancer were less likely than white men to receive any type of treatment.
Unfortunately, this trend is not unique to prostate cancer care. Many of these counties have been labeled by the government as healthcare deserts and lack access to primary care providers, OB/GYNs, oncologists, and other types of care, too.
How to find a doctor and get screened—no matter where you are
This September is Prostate Cancer Awareness month, and we’re teaming up with our partners at ZERO - The End of Prostate Cancer to connect men at risk of developing prostate cancer to the best doctors for screening and treatment.
There are two main ways to get screened for prostate cancer:
A digital rectal exam, also known as a DRE. A doctor will insert a gloved, lubricated finger into your rectum to feel for bumps or anything else unusual on your prostate.
A blood test for prostate-specific antigen, also known as a PSA test. This checks the level of prostate-specific antigen (PSA) in your blood. A PSA level of 4 nanograms or more per millimeter could be an early indicator of prostate cancer—but because everyone is different, a low PSA level doesn’t necessarily mean you don’t have prostate cancer, and a high PSA level doesn’t necessarily mean you do.
Despite its shortcomings, a PSA test is still the most accurate way to detect prostate cancer. The American Cancer Society recommends that men “learn as much as they can about prostate cancer screening risks and benefits and discuss the information with their doctor before deciding whether to be tested.” They suggest you should start discussing prostate cancer screening with your doctor at age 50, or age 40 if you know you have any risk factors.
Just search for “prostate cancer screening” on Amino below to see a map of all the doctors in your area who have experience with patients like you. Our experience badges will show which doctors see the most patients for prostate cancer screenings, and you can book an appointment through Amino for free.
If you live in an area with no prostate cancer screening doctors, try zooming out, then click “redo search in this area.” This can help you find a doctor who offers screenings nearby.
What to expect if your screening is abnormal
If your DRE or PSA results are abnormal, your doctor might encourage you to get a prostate biopsy to investigate further. A prostate biopsy is when a doctor uses a needle to remove a small sample of your prostate tissue, so a lab can test it for cancer cells.
Deciding whether or not to have a prostate biopsy can be difficult. Many men who have elevated PSA levels end up getting a biopsy that doesn’t show any cancer. Not only can these biopsies can cause unnecessary infection or bleeding—they’re not necessarily cheap. We found that a prostate biopsy costs about $877 on average, and it’s could cost nearly twice that in Alaska, at more than $1,600.
If a biopsy shows cancer cells, deciding between active treatment or surveillance can be also be difficult. Many prostate cancers are slow-growing, and there’s a lot to consider before making a decision on the best course of action. A study published earlier this year found that 15% of men with localized prostate cancer regretted the treatment decisions they made, often because active treatment can cause sexual dysfunction and other health issues. However, early screening can also save lives. Local and regional prostate cancer diagnoses have a five-year survival rate of more than 99%, whereas the five-year survival rate for advanced prostate cancer is just 29%.
Prostate cancer screening can be a complicated topic, so be sure to ask your doctor what’s right for you. Here are some questions our partners at ZERO - The End of Prostate Cancer suggest you ask:
- Am I at risk of getting prostate cancer?
- What are my options for getting tested?
- What if my test results are abnormal?
- What does an abnormal test result mean?
- What are my options if I am diagnosed with prostate cancer?
As there’s still a lot to be understood about both prostate cancer screening and treatment, be sure to consult your doctor and have an honest conversation about the best treatment plan for you.