Raised risk of prostate cancer in Black men

Black men living in England are three times more likely to get prostate cancer than White men and tend to be diagnosed five years younger, researchers have found.

The PROCESS study is the first population-based study to compare rates of prostate cancer between Black men and White men living in the United Kingdom. Researchers at Bristol University's Department of Social Medicine carried out the study in collaboration with colleagues at Bristol Royal Infirmary, Southmead Hospital, and in London.

Studies in the US had already reported a higher rate of prostate cancer in Black men, but it was unclear if this reflected a higher rate of diagnosis, or a difference in disease biology.

In the UK study, published in the British Journal of Cancer, the difference between black men and white men exceeded that in the US, and could not be fully explained by differences in how long the men delayed before seeing their doctor, differences in access to diagnostic services, or by differences in the information black men or white men had about the condition. Indeed, a higher average level of prostate specific antigen in Black men at diagnosis suggested that the difference in rates may be underestimated.

Dr Chris Metcalfe, Lecturer in Medical Statistics and collaborator on the project, said: "This is the first evidence from the UK on differences between Black and White men in rates of prostate cancer. "

He added: "There are very few known risk factors for prostate cancer but as we exclude a role for social factors, such as access to diagnostic services, it looks more likely that the higher rate in Black men is due to a biological susceptibility to developing the disease."

The researchers are now doing further work to see if there are differences in disease progression and survival following diagnosis between the two groups.

The paper, Pathways to diagnosis for Black men and White men found to have prostate cancer: the PROCESS cohort study, C Metcalfe, S Evans, F Ibrahim, B Patel, K Anson, F Chinegwundoh, C Corbishley, D Gillatt, R Kirby, G Muir, V Nargund, R Popert, R Persad and Y Ben-Shlomo on behalf of the PROCESS study group, British Journal of Cancer, advance online publication 16 September 2008.