Racial disparities in prostate cancer, why?

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Reviewed

Sep 5 2007

African-American men face a higher risk of developing prostate cancer in their lifetime, but researchers do not fully understand why.

“Many prostate cancer research programs include too few African Americans, yet African-American men have such a tremendously high risk of the disease, we felt it important to reach out to this community,” says Kathleen Cooney, M.D., professor of internal medicine and urology at the University of Michigan Medical School.

Cooney leads efforts at the U-M Comprehensive Cancer Center to focus research on understanding what genetic factors lead to this disparity for prostate cancer. Here's what researchers know:

African-American men have the highest incidence of prostate cancer in the world.
Prostate cancer tends to be more aggressive in African Americans compared to Caucasians.
African-American men are more likely to die from prostate cancer than their Caucasian counterparts.
Different genes may be involved in prostate cancer in African-American men than in Caucasian men.

“If the genetic risk factors are different between African-American men and Caucasian men, we need to know that in order to develop genetic tests appropriate for different populations,” says Cooney, interim chief of hematology/oncology and co-director of the urologic oncology program at the U-M Comprehensive Cancer Center.

“We hope to be able to find a gene or genes associated with risk for prostate cancer. Then we can develop genetic tests that will allow us to tell men what their likelihood of developing the disease may be. This information might result in more intense screening for men carrying the risk genes,” Cooney says.

This year, 218,890 men will be diagnosed with prostate cancer. About one of every six men will be diagnosed with prostate cancer in his lifetime. African-American men are 1.6 times more likely to be diagnosed with prostate cancer than Caucasian men.

Prostate cancer is the second-leading cause of cancer deaths in American men, with about 27,050 men expected to die from the disease this year. African-Americans are 2.4 times more likely to die from prostate cancer.

Other risks

Two other factors, in addition to race, increase the risk of prostate cancer:

Age. This is the main risk factor as prostate cancer seldom occurs in men younger than 45. The risk goes up sharply after age 65.
Family history. If your father or brother had prostate cancer, you're at an increased risk.

No matter what a man's risks, the key is early detection. The American Cancer Society recommends a PSA test and digital rectal exam every year beginning at age 50. PSA, which stands for prostate specific antigen, is a blood test that looks at the level of a certain protein in the prostate. Higher levels could indicate cancer. Men at higher risk of prostate cancer – either African-Americans or men with a family history – should begin screening earlier.

“If you're an African-American man and you have at least one brother affected with prostate cancer, you have a greater chance of being diagnosed with the disease compared to the general population. You should speak to your physician about being tested for prostate cancer with a PSA test, perhaps at an earlier age,” Cooney says.