Race and literacy effects on prostate cancer biology and access

6019 Background: African Americans present with a higher stage of disease for prostate cancer. Multivariate analysis indicates that low literacy rather than race, is the most likely predictor of advanced stage (Bennett, JCO 1998). We evaluate the relation of race and literacy with Gleason score, PSA level and treatment. Methods: Newly diagnosed prostate cancer patients were recruited from three Chicago Hospitals (N=143), including two equal access healthcare systems. Patients completed a demographic questionnaire and a literacy evaluation, using a 66 word standard list, the Rapid Estimate of Adult Literacy in Medicine (REALM). Stage of presentation and treatment decision were abstracted from medical records. Results: Patients were primarily African American (76%), of lower socioeconomic status (72%) with an income < $20,000, with low literacy skills (65% with <9th grade) and were older than 65 years of age (60%). Bivariate analysis indicated that race and low literacy were significantly associated with Gl...