AUTHOR REPLY

Abstract

We wish to expand on some of the excellent points made by Dr. Nyame in his editorial on our paper. While we also view race itself as largely a social construct, we recognize that important biological and environmental risk factors cluster by race and thereby affect prostate cancer risk and mortality. Such factors include vitamin D deficiency, genetic background and tumor gene expression along with factors which are intertwined with socioeconomic deprivation, including access to care, screening and smoking behaviors, body composition and diet. 1 Smith ZL Eggener SE Murphy AB African-American prostate cancer disparities. Curr Urol Rep. 2017; 18: 81 Crossref PubMed Scopus (31) Google Scholar Translational research on biomarkers tends to move ahead rapidly, and early studies often do not include enough Black men to permit analyses to detect differences in predictive value that could lead to race-specific test thresholds or alternate testing strategies. Thus, initial estimates of the balance between risk and harm related to a biomarker could be inapplicable for Black men, and opportunities to reduce the racial disparity could be lost.