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Prostate cancer in men of African origin

Nature Reviews Urology volume 13, pages 99–107 (2016)Cite this article

Subjects

Key Points

  • Prostate cancer incidence is highest among African-American men, prostate cancer mortality is highest among Afro-Caribbean men, and tumour stage and grade at diagnosis are highest among men in sub-Saharan Africa

  • Socioeconomic, cultural, and genetic factors, as well as variations in care delivery and treatment selection, contribute to the prostate cancer disparity among men of African origin

  • Emerging data on unique single-nucleotide-polymorphism patterns, epigenetic changes, and variations in fusion gene products among men of African origin add to the understanding of the genetic differences underlying this disease

  • Men of African origin present with higher PSA levels, are less likely to receive curative therapy, and have higher rates of biochemical recurrence after surgery than white men

  • Understanding differences in the cancer-survivorship experience and quality-of-life outcomes for men of African origin are critical to appropriately counsel patients

  • Efforts to curtail PSA screening should be watched closely, as this policy could worsen the racial disparity in prostate cancer

Abstract

Men of African origin are disproportionately affected by prostate cancer: prostate cancer incidence is highest among men of African origin in the USA, prostate cancer mortality is highest among men of African origin in the Caribbean, and tumour stage and grade at diagnosis are highest among men in sub-Saharan Africa. Socioeconomic, educational, cultural, and genetic factors, as well as variations in care delivery and treatment selection, contribute to this cancer disparity. Emerging data on single-nucleotide-polymorphism patterns, epigenetic changes, and variations in fusion-gene products among men of African origin add to the understanding of genetic differences underlying this disease. On the diagnosis of prostate cancer, when all treatment options are available, men of African origin are more likely to choose radiation therapy or to receive no definitive treatment than white men. Among men of African origin undergoing surgery, increased rates of biochemical recurrence have been identified. Understanding differences in the cancer-survivorship experience and quality-of-life outcomes among men of African origin are critical to appropriately counsel patients and improve cultural sensitivity. Efforts to curtail prostate cancer screening will likely affect men of African origin disproportionately and widen the racial disparity of disease.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, DUMC 3707, Duke University, Durham, 27710, North Carolina, USA

    Kathleen F. McGinley, Kae Jack Tay & Judd W. Moul

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  1. Kathleen F. McGinley
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  2. Kae Jack Tay
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  3. Judd W. Moul
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K.F.M. and K.J.T. researched data for and wrote the article, J.W.M. reviewed the content and all authors reviewed and edited the manuscript before submission.

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Correspondence to Judd W. Moul.

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McGinley, K., Tay, K. & Moul, J. Prostate cancer in men of African origin. Nat Rev Urol 13, 99–107 (2016). https://doi.org/10.1038/nrurol.2015.298

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