African Americans: At Higher Risk for Prostate Cancer ~ October 05, 2012—Of the more than 242,000 American men who will be diagnosed with prostate cancer and the 28,000 who will die as a result of it this year, a disproportionate number of African-American men will be represented in each group. The disparity is eye opening: African-American men are nearly 1.6 times more likely to be diagnosed with prostate cancer than Caucasian men and 2.4 times more likely to die from the disease.
Although scientists do not yet fully understand why prostate cancer incidence and death rates are higher within the Africa-American population, it is widely believed that a combination of factors and disparities likely play a combinative role in the statistics, and in some cases, create a perfect storm for diagnosis of aggressive disease.
“Despite ongoing controversies concerning the benefit of prostate cancer screening and treatment of localized disease, prostate cancer continues to be the second most common cause of cancer deaths in the United States. In addition to the thousands of men that die from prostate cancer each year, many more will deal with the debilitating consequences that occur when the cancer spreads to other areas of the body, most commonly the bone, resulting in severe pain, fractures, and other serious medical complications,” says Isla Garraway, MD, PhD, a prostate cancer researcher at UCLA.
“African-American men, in particular, display increased risk of suffering and death from prostate cancer, compared to men of other ancestral backgrounds. Black men are more likely to be diagnosed with prostate cancer, are diagnosed at a younger age, display larger tumors, and are more than twice as likely to die from prostate cancer that has spread throughout the body than white males ,” adds Garraway.
Dr. Garraway and her brother, Levi Garraway, MD, PhD at the Dana-Farber Cancer Institute and Harvard University are both prostate cancer researchers funded by the Prostate Cancer Foundation (PCF). They are African-American and lost their father to the disease while in graduate school. Their loss inspired them to focus their scientific careers in prostate cancer research.
Dr. Garraway goes on to say that there are many factors that may cause these differences. Studies have shown that African-American men may have reduced access to and quality of care that may result in diagnosis and treatment of prostate cancer at later stages (after the disease has spread outside of the prostate). Other factors may be related to diet, exposures and co-existing medical conditions that influence the severity of the cancer. Finally, there may be specific differences in genes that are expressed in the prostate tissue of African-America men, resulting in increased susceptibility to the development of more aggressive disease. The key to eliminating disparities among men with prostate cancer is to understand these differences by defining relative medical, socioeconomic, and genetic contributions to prostate cancer progression. Ultimately, new tools that can predict the behavior of tumors and eliminate the spread of aggressive cancer will be illuminated, which will benefit all men.
One of the major barriers to identifying the disparity of prostate cancer among African-American men has been the lack of epidemiological studies with the inclusion of sufficient numbers of men across different races. We may also gain insight by studying the demographic shift and related increased rates of prostate cancer seen in parts of Africa. The good news is that scientists, legislators and advocacy groups are bringing new emphasis to this perplexing reality.
This past July, U.S. Sen. John F. Kerry (D-MA) led unanimous passage of the Senate Resolution 493 to recognize prostate cancer as an epidemic striking African American men disproportionately. This bipartisan legislation urges federal agencies to support research for the advancement of diagnostic tools, including novel biomarkers and imaging technologies. Improved diagnostic tools will save lives and assure individualized, the least invasive and the most cost-effective patient care in millions of American men.
Senator Kerry said, “Prostate cancer is an epidemic – it kills every 16 minutes. This disease killed my dad, but I was lucky to beat it ten years ago. I introduced this resolution in the Senate to bring attention to this silent killer, how it disproportionately affects African Americans, and the need for additional federal investment in prostate cancer research, education, and awareness. I’ve been through the battle against prostate cancer and I understand the strain a diagnosis places on the patient and their loved ones. We need to stay focused on research and arm Americans with the tools to prevent, detect, cure and treat this disease, and I’m grateful to my colleagues and our advocates for pushing this resolution through.”
Ongoing research sponsored by PCF in epigenetics, genetics, and diet and lifestyle will shed further light on the disparities in prostate cancer between African Americans and other racial groups. Funding for this type of research remains crucial.
Dan Zenka, APR, is senior vice president of communications at the Prostate Cancer Foundation. Two years after joining PCF, he was diagnosed with advanced metastatic disease. He also writes a popular prostate cancer blog that can be found at www.mynewyorkminute.org.
~ Dan Zenka