Black men exhibit higher rates of prostate cancer for many complex reasons. This article explores both the social and genetic factors at play.
Among all forms of cancer, prostate cancer displays the widest racial disparities, which persist at every stage that the cancer presents. This article, published in Prostate Cancer and Prostatic Diseases, analyzes these disparities between Black and White men. The comparison ranged from prevention and screening to clinical outcomes and found that Black men exhibit double the rate of prostate cancer mortality, and 60% greater incidence compared to White men.
The survival rate for Black men is significantly lower than it is for White men, but this disparity does not persist in situations where equal treatment is presented, such as in clinical trials or men treated in the Veterans Affairs. The authors suggest that these racial disparities are primarily caused by social, economic, access to care, environmental, lifestyle, and genetic differences across Black and White men.
Prostate cancer screening is lower among Black men, even though incidence and mortality are higher in this population. The authors note that despite this fact, the United States Preventive Services Task Force does not provide heightened screening recommendations for this at-risk population. Risk-stratified screening practices are one suggestion that could potentially reduce prostate cancer mortality among black men, with one study showing that annual screening in Black men aged 45-69 could reduce mortality and overdiagnosis.
The authors conclude that the best explanations for the disparity in prevalence and outcome of prostate cancer among Black men are higher overall incidence, higher rates of harmful exposure that cause aggressive prostate cancer, lower access to care, and lower prevalence of screenings. The way that these factors relate to each other is not fully understood, and the authors note that further research into each mechanism of action would allow for more targeted prevention programs.
Reference
Chowdhury-Paulino, I. M., Ericsson, C., Vince, R., Jr., Spratt, D. E., George, D. J., & Mucci, L. A. (2022). Racial disparities in prostate cancer among black men: epidemiology and outcomes. Prostate Cancer Prostatic Dis, 25(3), 397-402. https://doi.org/10.1038/s41391-021-00451-z
