Is prostate cancer different in black men? Answers from 3 natural history models

Abstract

Background Black men in the US have substantially higher prostate cancer incidence rates than the general population. The extent to which the incidence disparity is due to prostate cancer being more prevalent, more aggressive, and/or more frequently diagnosed in black men is unknown. Methods We estimated three independently developed models of prostate cancer natural history in black men and in the general population using an updated reconstruction of PSA screening, based on the National Health Interview Survey in 2005, and prostate cancer incidence from the Surveillance, Epidemiology, and End Results program in 1975–2000. Using the estimated models, we compared prostate cancer natural history in black men and in the general population. Results The models projected that 30–43% (range across models) of black men develop preclinical prostate cancer by age 85 years, a risk that is (relatively) 28–56% higher than in the general population. Among men who have had preclinical disease onset, black men have a similar risk of diagnosis (35–49%) compared with the general population (32–44%), but their risk of progression to metastatic disease by the time of diagnosis is 44–75% higher than in the general population. Conclusions Prostate cancer incidence patterns implicate higher incidence of preclinical disease and higher risk of metastatic progression among black men. The findings suggest screening black men earlier than white men and support further research into the benefit-harm tradeoffs of more aggressive screening policies for black men.

Comparative effectiveness of prostate cancer screening between the ages of 55 and 69 years followed by active surveillance

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Cancer statistics for African Americans, 2019

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The 22Rv1 prostate cancer cell line carries mixed genetic ancestry: Implications for prostate cancer health disparities research using pre‐clinical models

“…African American (AA) men and other men of African ancestry have the highest incidence and mortality rates of prostate cancer (PCa) in the world, resulting in the highest reported cancer health disparity . We use the term “African American” recognizing that while race is a social construct, racial classification remains extremely useful for describing general patterns of national health and health disparities, as most US health data are reported by self‐identified race .…”