IPCF advocate Oscar Robertson and IPCF founder Dr. Vipul Patel discuss prostate cancer and the black community

DID YOU KNOW? Black men in the United States are more likely to be diagnosed with and to die from prostate cancer vs. men of other backgrounds.

Although all men are at a risk for prostate cancer, Black men are at higher risk. A risk factor is anything that affects your chance of getting a disease. Different cancers have different risk factors. Some risk factors, like smoking or diet, can be changed. Others, like a person’s age or family history, can’t be changed.

Having one or several risk factors does not mean that you will get the disease. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors. However having risk factors does increase the probability of developing the disease.

Age & Family History
Age is one of the main risk factors for prostate cancer in Black men, and the disease is rare in men younger than 45. Black men with a father or brother who had prostate cancer when they were younger than age 65 should start screenings at age 45, and Black men with more than one close relative who had prostate cancer when they were younger than age 65 should start screenings at age 40.

Geography
Prostate cancer is most common in North America, northwestern Europe, Australia, and the Caribbean islands. Black men in the United States and the Caribbean have the highest prostate cancer incidence rates in the world. It is less common in Asia, Africa, Central America, and South America.

The reasons for this are not clear. More intensive screening in some developed countries probably accounts for at least part of this difference, but other factors such as lifestyle differences – one example being diet – are likely to be important as well.

Race
Prostate cancer more common in Black men than in Caucasian men. Black men are 1.7 times more likely to be diagnosed with — and 2.1 times more likely to die from — prostate cancer than white men. See the Impacting Factors section to the left for more information on why Black men are affected more.

Certain Prostate Changes & Inflammation
Men with cells called High-Grade Prostatic Intraepithelial Neoplasia (PIN) may be at increased risk. These prostate cells look abnormal under a microscope. Some studies have suggested that prostatitis (the inflammation of the prostate gland) may be linked to an increased risk of prostate cancer, but other studies have found no such link. Inflammation is often seen in samples of prostate tissue that also contain cancer. The link between the two is not yet clear and is an active area of research.

Genetics
Inherited, biological factors could be a factor. Black men tend to have a more aggressive cancer and, usually at diagnosis, Black men present with a more advanced stage. Some studies have shown that prostate cancer in Black men presents a different genetic profile — scientists have discovered genetic mutations that are unique and could help explain why Black men are at a higher risk than other ethnicities. These findings could lead to a test to identify those at greatest risk of developing the disease, enhancing survival rates.

Low Enrollment in Clinical Studies
and Lack of Adequate Access to Health Care
Black men are usually not well represented in clinical trials and recruitment is low, so the results of many prostate cancer clinical trials don’t necessarily apply to Black men since they weren’t accurately represented in the clinical trial. Initiatives need to be created to boost clinical trial participation in many cancers such as breast, colorectal, lung and prostate cancers, as these cancers are more likely to result in death for Black people when compared to other racial and ethnic groups.

The American health care system is beset with inequalities that have a disproportionate impact on the Black community and other marginalized groups. Inequalities create gaps in health insurance coverage, uneven access to services, and poorer health outcomes among certain populations and ethnic groups. Black communities bear most of these health care challenges.

Black men tend to get less active treatment and less surgical solutions than other men. It’s probable there are a combination of multiple factors that contribute to this, such as: bias in the community, lack of trust in the healthcare system, or lack of access to health centers of excellence.