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We Need More Black Urologists

A war is being waged to close the gap in diagnosis, treatment and death related to prostate cancer between African American men and those of other races. The battlefields include the relative dearth of black men involved in research and clinical trials, and a similar lack of black practitioners, from whom black men are more likely to seek regular exams and treatment.

It is no coincidence that in the numerous studies done over the last two decades on why the disparities in prostate health and treatment still exist, black urologists are regularly part of the research teams and study authors. And the odds are strong that those urologists are members of the R. Frank Jones Urologic Society, a professional organization of black urology specialists named for the pioneering long-time head of urology at Howard University Medical School and medical director of what was long known as Freedmen’s Hospital in Washington.

The group’s current president, Tracy Downs, M.D., of the University of Wisconsin School of Medicine and Public Health, co-authored one of the more recent studies, in 2017. A study by the medical school of cancer rate disparities in Wisconsin over a roughly two-decade span, concluded that black men had a 71 percent higher chance than white men of being diagnosed with prostate cancer, and a 73 percent higher chance of death.

Meanwhile, according to a 2015 study, only 7.5 percent of the overall pool of applicants to urology programs are African Americans, and they represent just 4 percent to 5 percent of urology residents and 1percent to 2 percent of urology faculty members. 

Among all the increases in cancer rates revealed by the 2017 study, “prostate uniquely jumps off the page,’’ Downs said in an interview appearing on the Wisconsin medical school’s website.

As much of it stemmed from black men not getting screened and hearing either mixed messages about whether to do so or no message at all. “If the message would have come from someone they trust, someone who lives in their community, giving advice on the benefits of the exam, they would have more likely heard it and acted on it,” Downs added.

That’s where the still-low number of urologists come in, and the importance of the R. Frank Jones group, which belongs to both the National Medical Association and the American Urological Association. The teaching and mentorship of Jones (1897-1979), who retired in 1970 after 47 years, and whose teaching and mentoring his namesake society yearns to duplicate.

A 2013 report by the AUA said that 50 percent of black urology residents had other black residents present during their training. Just as with a potential prostate patient, the impact of seeing one’s own in the practice is clear, statistically—and anecdotally.

“While I was in college I met some good role models who suggested I consider medicine,’’ Downs recalled in an earlier interview, “and an African American pediatrician played a critical role in my getting into medical school.’’

—David Steele

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