When it comes to prostate cancer, race matters; and the difference is between black and white. Not only are black men at higher risk for prostate cancer, but a new study suggests that the definition of low-risk prostate cancer should be different — more stringent — for black men than it is for white men.

Prostate Cancer In Black And White

Let’s look at what experts have found up to this point. Previous research has shown there is a clear gap between black and white when it comes to prostate cancer. According to a report from the Centers for Disease Control and Prevention reflecting 2009 figures, the incidence rate (how many men get the disease each year) of prostate cancer among black men was approximately 220 per 100,000, compared with about 130 per 100,000 for whites and about 120 per 100,000 for Hispanics. ^[1]

Prostate cancer in black men also tends to be more aggressive than among men of other races. Experts learned one reason why this is true in a study published in the Journal of Urology. Researchers evaluated the prostate glands of 1,056 men (black and white) who had died of causes other than prostate cancer, as well as the glands of 2,874 men who had undergone radical prostatectomy. After analyzing all the data, the authors found that prostate cancer volume was higher for black men than it was for whites, and that the chances of having advanced or aggressive prostate cancer were 4-to-1 for black men compared with white men. ^[2]

Why do black men have a higher risk of prostate cancer than men of other races? One reason has to do with genetics. A Harvard School of Public Health study reported that genetic differences between blacks and whites may be a determining factor in the prevalence of prostate cancer and black men. ^[3]

Vitamin D may be another reason. This nutrient helps protect against prostate cancer, but vitamin D deficiency is high among black men because of their dark skin. A study from Fox Chase Cancer Center, for example, found that 61 percent of 194 black men being evaluated in a risk assessment for prostate cancer had vitamin D insufficiency. The authors concluded that “the problem of low vitamin D status in African American men may be more severe than previously reported,” and that steps should be taken to “improve vitamin D status in this particularly vulnerable population.” ^[4]

New Research

Researchers at The Cancer Institute of New Jersey recently published a new study about prostate cancer in black men. ^[5] They found that the prevalence of advanced prostate cancer in black men who were considered to have low-risk cancer at their initial consultation but who elected to undergo radical prostatectomy was nearly double that of white men. This finding led the authors to question the definition of low-risk prostate cancer and to suggest there should be a separate definition of this type of cancer for black men when it’s time for them to consider treatment options.

Generally, active surveillance (monitoring prostate cancer without aggressive intervention) is a popular consideration for men who have low-risk prostate cancer. However, since black men tend to have more aggressive prostate cancer than do white men, the concept of “low-risk” prostate cancer appears to be different for blacks. Therefore, according to the study’s senior author, Isaac Yi Kim, M.D., Ph.D., chief of the Section of Urologic Oncology at the The Cancer Institute of New Jersey: “Our findings suggest that more stringent criteria may be needed for those in this population [African American men] who are considering active surveillance,” at least until experts are able to develop more biomarkers and more refined imaging techniques to better identify the risks of prostate cancer patients.”

For more information about prostate cancer and prostate health, visit prostate.net.

Sources

[1] CDC Prostate Cancer Rates by Race and Ethnicity:
http://www.cdc.gov/cancer/prostate/statistics/race.htm

[2] Evidence supports a faster growth rate and/or earlier transformation to clinically significant prostate cancer in black than in white American men, and influences racial progression and mortality disparity.
http://www.ncbi.nlm.nih.gov/pubmed/20299055

[3] Racial variation in prostate cancer incidence and in hormonal system markers among male health professionals.
http://www.ncbi.nlm.nih.gov/pubmed/11121463

[4] Prevalence and correlates of vitamin D status in African American men.
http://www.ncbi.nlm.nih.gov/pubmed/19534831

[5] Increased incidence of pathologically organ confined prostate cancer in African-American men eligible for active surveillance.
http://www.goldjournal.net/article/S0090-4295(13)00071-X/abstract