In the United States, African American men are more likely to be diagnosed with prostate cancer than white men, tend to be diagnosed at younger ages and with more advanced disease, and are more than twice as likely to die of the disease. The reasons for these disparities have not been clear. “There is a perception among some in the medical community that prostate cancer is inherently more aggressive among African American men, and that there’s nothing we can do about” disparities in deaths from the disease, said Brent Rose, M.D., a radiation oncologist at the University of California at San Diego. But some studies have pointed to differences in access to health care as a cause of the disparities, and a new study by Dr. Rose and his colleagues supports that hypothesis. The team found that among patients treated in the US Department of Veterans Affairs (VA) health care system—where all patients have equal access to care—African American men did not appear to have more-aggressive prostate cancer at the time of diagnosis or a higher death rate from the disease than non-Hispanic white men. “Well-designed observational studies like this one are important for helping us to better understand the importance of access to care,” said Janet de Moor, Ph.D., M.P.H, of the Healthcare Delivery Research Program in NCI’s Division of Cancer Control and Population Sciences, who was not involved with the study. “This study, while imperfect, definitely adds to our understanding of racial disparities in prostate cancer outcomes,” agreed David Penson, M.D., M.P.H., a urologic oncologist and health services researcher at Vanderbilt University, who also was not involved in the study. The study, published January 27 in Cancer, suggests that providing equal access to health care could be important for eliminating or reducing disparities in prostate cancer deaths, Dr. de Moor said.