Prostate Cancer and African-American Men

February 24, 2021

Prostate cancer is a significant health problem in the United States with about one in nine men diagnosed with prostate cancer in his lifetime. Prostate cancer develops mainly in older men and in African-American men. About six cases in ten are diagnosed in men aged 65 or older. And one in three Black American males will be diagnosed with prostate cancer in the U.S. The death rate for all cancers, including urologic cancers, in the U.S. is 25% higher for African Americans than for Caucasian men.

What causes prostate cancer is a subject of intensive research. It is likely that prostate cancer occurs due to many reasons. Some known risk factors include family history and obesity. Even without those factors African-American men are at a higher risk for developing the disease.

African-Americans are in the highest risk group for prostate cancer, with an incidence of more than 200 cases per 100,000 men. African American men also tend to present with more advanced disease and have a poorer overall prognosis than Caucasian or Asian men. According to the Prostate Cancer Foundation, African-American men are nearly 1.6 times more likely to develop prostate cancer than Caucasian men. They are also 2.4 times more likely than Caucasian men to die from the disease.

Additionally, African American men are at higher risk of dying from low-grade prostate cancer. A recent study has found that the risk is double that of men of other races. The findings of the study have identified racial differences in the biology and presentation of low-grade prostate cancer noting that certain biological factors may make low-grade prostate cancer more likely to grow and spread in African American men than in men of other races.

Although no definitive reasons as to why prostate cancer incidence and death rates are higher for African-American men has been found, there are a few possibilities worth noting:

-Late detection.

-Biological differences: such as genomic features of prostate tumors. Suggesting differences in tumor genomics that may make low-grade prostate cancer more aggressive in African American men.

-Limited biopsies: Traditional prostate biopsies used to detect prostate cancer may be more likely to miss areas of high-grade prostate cancer in African American men. A 2014 study found that African American men are more likely to have tumors in the anterior region of the prostate, which is harder to reach with a traditional transrectal biopsy, leading to a higher likelihood of misdiagnosis of low-grade disease. However, today advances in MRI technology have resolved this issue, as it allows for the suspicious areas in the anterior prostate to be identified before a biopsy which reduces missing high-grade tumors in this part of the prostate gland.

-Cultural and lifestyle habits.

-Access to medical care.

-Distrust of the medical system.

The good news is that through extensive research and medical trials, the projected deaths from prostate cancer in African American men have dropped by more than 50% in the last 20 years. And even though the risk for African-American men is still greater, the gap between five-year survival rates of prostate cancer in Caucasian and African American men has shrunk.

So what’s the best approach to preventing prostate cancer in African American men? Early detection, easy access to healthcare and annual prostate cancer screenings. The easiest way to detect prostate cancer, and catch it early, is be diligent about getting screened. The requirement for annual screening depending on age, ethnicity, family history and other risk factors is simple.

Prostate cancer screening involves a blood test called a PSA (prostate specific antigen) and a prostate exam (DRE or digital rectal exam). This can be performed by a primary care physician or a urologist. Recently, genetic testing has been made available which can aid in determining prostate cancer risk if there is a strong history of prostate cancer in the family.

For more information about prostate cancer or for prostate cancer screening, contact Austin Urology Institute at (512) 694-8888 to make an appointment with a provider.