Genetic and Biological Drivers of Prostate Cancer Disparities in Black Men - Beyond the Abstract
This was recently highlighted by our group as well in a sister publication on this topic in the Journal of Clinical Oncology entitled “Disparities with Systemic Therapies for Black Men Having Advanced Prostate Cancer: Where Do We Stand?”.1 In considering both biological and non-biological drivers of prostate cancer disparities, it has been brought up that use of self-reported race should be considered a limitation of such research. However, we would argue that this can alternatively be viewed as a strength in cancer disparities research. For example, in the sense that race is a social construct, if someone believes they are part of a social group, whether they share genetic ancestry with those in the group or not, they will share similar experiences (i.e., systemic racism, dietary patterns, etc.).
As such, ultimately, we believe that self-reported race, despite the limitations, is a very valid means to study the impact of “race” on prostate cancer. Ultimately, future efforts to better understand and address biological differences and access-related barriers to care contributing to prostate cancer disparities will be tremendously aided by: 1) systematic biobanking efforts aiming to render biospecimens from patients with prostate cancer across all races readily available for the study of biologic and/or genetic factors impacting disease biology and treatment outcomes and 2) participation in clinical trials. With a larger knowledge base from these studies, we can inform providers, patients, advocates, and policymakers on the importance of both biological and non-biological drivers of prostate cancer disparities.
These findings can support outreach strategies aiming to expand awareness of such racial disparities in prostate cancer treatment outcomes and programmatic efforts to mitigate barriers to access to care. Future results may also impact clinical decision-making and clinical trial design in prostate cancer based on race and, more specifically, presence or absence of molecular features unique to certain racial groups.
Written by: Jun Gong, MD, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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