Aggressive Prostate Cancer in Men of African Ancestry

Biological and non-biological factors associated with aggressive prostate cancer in men of African ancestry seem to persist despite endless pursuits from the medical research community. The defining factors, such as social stress, tumor markers, environmental factors, and genetics, all play important roles in better understanding the aggressive nature of prostate cancer among this population.

This is particularly alarming as we seek to understand why the disease spreads so quickly in comparison to men of other racial and ethnic groups. Future research in this area must combine state-of-the-art molecular approaches with environmental and social science that might lead to tailored approaches for prevention, diagnosis, and treatment.¹

What does previous research show?

A broad-based study of DNA and tumor samples to identify gene variants associated with aggressive prostate cancer is one avenue that might help shed additional light on this important issue. As an African American prostate cancer survivor and father of 2 sons and a grandson, I feel this research is long overdue, particularly since little is known about biological and environmental factors that impact these disparities. I applaud NIH and the Prostate Cancer Foundation in taking a leadership role to address this crisis.

Adding to the complexity of this issue is that prostate cancer occurrences for men of African ancestry in the United States is typically presented in aggregate without regard to country of origin of birth, thereby masking important potential differences that can inform cancer prevention, programs, and policies. Some of the research in this area shows that men of African descent, particularly originating from Western Africa, are known to have the highest rates of prostate cancer worldwide, suggesting there may be shared genetic risk factors.

Does risk differ for Sub-Saharan African-born men?

How does this compare to Sub-Saharan African-born Black people in the United States? Ironically, research findings have shown that prostate cancer, as the most frequently diagnosed cancer in African American men, was consistent with data among Black men born in sub-Saharan Africa. According to data from the American Community Survey, Sub-Saharan African born Black people represent one of the fastest growing populations in the United States. However, data regarding prostate cancer among this group remains severely limited in scope.

Further scientific inquiries in this area could stimulate etiologic research and help to inform targeted cancer control interventions among men of African descent. In a similar fashion, research conducted in Latin America and the Caribbean shows that prostate cancer is the most frequently diagnosed cancer.

An aim for future research

Understanding the aggressive nature of prostate cancer in these countries will require national health plans that establish public policies for prostate cancer control, adequate financing, and health expenditures that are aimed at non-transmissible chronic diseases. These linkages among men of African descent must begin with awareness, followed by organizing and mobilization drives that will force policymakers to release the critical funding required to advance the cause of health equity for all men who are impacted by this disease.