Prostate cancer is the second most commonly diagnosed non-skin malignancy and the second leading cause of cancer death among men in the USA. However, the mortality rate of African American men aged 40-60 years is almost 2. 5-fold greater than that of European American men. Despite screening and diagnostic and therapeutic advances, disparities in prostate cancer incidence and outcomes remain prevalent. The reasons that lead to this disparity in outcomes are complex and multifactorial. Established non-modifiable risk factors such as age and genetic predisposition contribute to this disparity; however, evidence suggests that modifiable risk factors (including social determinants of health, diet, steroid hormones, environment and lack of diversity in enrolment in clinical trials) are prominent contributing factors to the racial disparities observed. Disparities involved in the diagnosis, treatment and survival of African American men with prostate cancer have also been correlated with low socioeconomic status, education and lack of access to health care. The effects and complex interactions of prostate cancer modifiable risk factors are important considerations for mitigating the incidence and outcomes of this disease in African American men.
Nature reviews. Urology. 2024 Feb 02 [Epub ahead of print]
Jabril R Johnson, Nicole Mavingire, Leanne Woods-Burnham, Mya Walker, Deyana Lewis, Stanley E Hooker, Dorothy Galloway, Brian Rivers, Rick A Kittles
Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA. ., Department of Physiology, Morehouse School of Medicine, Atlanta, GA, USA., Department of Diabetes and Cancer Metabolism, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, USA., Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA., Department of Population Sciences, Division of Health Equities, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.