Racial Differences in Prostate Cancer
Cancer development, treatment, and outcomes are tricky topics to understand. The underlying reasons why a person gets cancer or how they might respond to treatment are often unknown and depend on a variety of factors. Just as we can study different risk factors and treatments, we can study different characteristics of people with cancer. Learning more about the individuals getting cancer and their overall outcomes can help us develop new treatments and better identify those at risk.
Many different cancer characteristics have been studied in recent years. However, there has been a growing interest in learning more about race and ethnicity in relation to prostate cancer. In honor of Minority Cancer Awareness Month, interesting findings from a few studies on the topic are below.
Who is getting prostate cancer?
Many familiar with prostate cancer may already be aware of one of the biggest differences in demographics: the disproportionate impact on Black men. Black men are thought to be at least 1.5 times more likely to get prostate cancer than their White counterparts, and 3 times more likely than Asian and Pacific Islanders. Another minority group, Latino men, have about the same likelihood of getting prostate cancer as White men. Both groups are about half as likely to get prostate cancer as Black men.1,2
Differences in diagnosis and outcomes
Black men are often diagnosed at earlier ages and with more aggressive prostate cancer than White men. Specifically:
- Their cancers are typically later stage and have a greater chance of recurring and/or metastasizing.
- Black men may receive fewer PSA tests, have stronger family histories of prostate cancer, be overweight or obese, and come from lower financial backgrounds. All factors that may play a role in cancer development.
- Black men may also be more likely to smoke and have a higher likelihood of having other life-impacting medical conditions, such as diabetes.
- Black men are around 2.2 times more likely to die from prostate cancer than White men.
- Further, they are around 4.5 times more likely to die than Asian and Pacific Islanders.
- In the United States, Black men make up about a third of all prostate-cancer related deaths.1,3,4
Latino men have similar 5-year survival rates as White men. However, they have a greater risk of being diagnosed with advanced or metastatic cancer.1,2
Variation in treatment
Treatment experience may vary based on racial and ethnic differences as well. One study found that Black men were disproportionately affected by treatment underuse (not getting the treatment they needed). This was often because of system failures, where a doctor recommended treatment, but it was never actually received. Other treatment variations found in studies include:
- Black men are more likely to be treated non-surgically and with radiotherapy.
- White men with prostate cancer are more likely to receive surgery.
- Black and Latino men may participate in watchful waiting more often than definitive treatment and are less likely to be a part of clinical trials.
- Minority groups are also more likely to experience delays between diagnosis and treatment.1,2,4,5
What does it all mean?
Overall, these results suggest that there are differences in cancer development, treatment experience, and survival with prostate cancer between racial and ethnic groups. The reasons for this are not well understood and may be related to a variety of different factors. Some of these may be related to genetics, environmental or work exposures, social factors, financial issues, lifestyle practices, diet, access to healthcare and helpful resources, and more.
This is such an important topic to talk about, as differences in treatment options, high mortality rates, and more aggressive cancers can take a huge toll on quality of life. However, this information is only from a few studies, and much more research is needed to understand the factors at play. For the time being, studies like these can help call out the differences in general, and may help doctors better diagnose and treat people from all backgrounds.
Resources for minority groups with prostate cancer
This information may seem overwhelming and confusing, especially for individuals belonging to minority groups that appear to have worse outcomes. It is okay to ask for help and support as you navigate your journey.
While some large organizations have resources designed for everyone living with prostate cancer, there are some minority-specific organizations that can help as well. Several resources to consider if you or a loved one with prostate cancer belongs to a minority group include the following:
- Malecare: Supports male cancer survivors, including underserved populations, like minority men with cancer.
- National LGBT Cancer Network: Supports LGBT cancer survivors through training, education, and support groups.
- Us TOO International, Inc: Provides information and support to men with prostate cancer.
- Prostate Health Information Network: An organization by and for Black men and their caregivers providing support and education.
- Prostate Cancer Research Institute: Connects men with prostate cancer to information, clinical trials, support and conferences.
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