Is Prostate Cancer More Aggressive in Black Men?

Black men take note: researchers have uncovered a possible reason why black men of West African ancestry are more likely than white men to get a prostate cancer diagnosis and to die of the disease. Autopsies of the prostate glands of more than 1,000 black and white American men suggest that the rate of prostate cancer growth is more rapid in black men and/or the cancer changes from a latent form to an aggressive prostate cancer form earlier in black men than in white.

It is well established that the risk of prostate cancer in black men is about 60% higher than it is among white men and that the mortality rate is 2 to 3 times greater as well. What has puzzled experts, however, is why these situations are true.

A study published in the Journal of Urology sheds some light on these mysteries. Researchers analyzed the prostate glands from 1,056 black and white men age 20 to 80 who had died of causes other than prostate cancer, as well as the prostate glands of 2,874 men who had undergone radical prostatectomy.

Among the autopsied prostate glands, the prevalence of prostate cancer was similar between black and white men, as were the volume of the prostate cancer in men ages 20 to 60 and the Gleason grade of cancer through age 70.

But when the authors looked at the prostates of the men who had undergone prostatectomy, they found that the prostate cancer volume was greater for black men ages 39 to 70 than it was for whites, and that the chances of having advanced prostate cancer or prostate cancer that had spread were 4 to 1 for black men compared with white men.

Although all men should take steps to ensure the health of their prostate and consider prostate cancer screening, including a prostate-specific antigen (PSA) test and a digital rectal exam (DRE) as they get older, black men should be screened for prostate cancer beginning at age 40 to 45, which is 5 to 10 years earlier than what is recommended for white men. Since black men are at greater risk for fast-growing and aggressive prostate cancer, earlier screening is a prudent step.

Read more in our Prostate Cancer Health Center.

Reference

Powell IJ et al. 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. J Urol 2010 May; 183(5): 1792-97


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