Abstract

Prostate cancer (PCa) is the second most frequently diagnosed malignancy and the second leading cause of death in men worldwide, after adjusting for age. According to the International Agency for Research on Cancer, continents such as North America and Europe report higher incidence of PCa; however, mortality rates are highest among men of African ancestry in the western, southern, and central regions of Africa and the Caribbean. The American Cancer Society reports, African Americans (AAs), in the United States, have a 1.7 increased incidence and 2.4 times higher mortality rate, compared to European American’s (EAs). Hence, early population history in west Africa and the subsequent African Diaspora may play an important role in understanding the global disproportionate burden of PCa shared among Africans and other men of African descent. Nonetheless, disparities involved in diagnosis, treatment, and survival of PCa patients has also been correlated to socioeconomic status, education and access to healthcare. Although recent studies suggest equal PCa treatments yield equal outcomes among patients, data illuminates an unsettling reality of disparities in treatment and care in both, developed and developing countries, especially for men of African descent. Yet, even after adjusting for the effects of the aforementioned factors; racial disparities in mortality rates remain significant. This suggests that molecular and genomic factors may account for much of PCa disparities.

Highlights

  • It is estimated that 1 in 9 men in the United States (U.S.) will be diagnosed with prostate cancer (PCa) in their lifetime [1]

  • As a result of genetic ancestry, differences in innate immune response has led to investigation of essential genes, such as OAS1 (OligoAdenylate Synthetase gene 1)/RNASEL, that may play a role in response to pathogens and prostate cancer disparity [89, 90]

  • To further elucidate biological determinants that may play a role in PCa disparities, recent studies have investigated genomic alterations in prostate tumors derived from AA compared to European American (EAs) men [125]

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Summary

Frontiers in Oncology

According to the International Agency for Research on Cancer, continents such as North America and Europe report higher incidence of PCa; mortality rates are highest among men of African ancestry in the western, southern, and central regions of Africa and the Caribbean. Recent studies suggest equal PCa treatments yield equal outcomes among patients, data illuminates an unsettling reality of disparities in treatment and care in both, developed and developing countries, especially for men of African descent. Even after adjusting for the effects of the aforementioned factors; racial disparities in mortality rates remain significant. This suggests that molecular and genomic factors may account for much of PCa disparities

INTRODUCTION
PROSTATE CANCER INCIDENCE AND MORTALITY RATES
HEREDITARY PROSTATE CANCER GENES
Replication Sample Number and Ancestry
NR Intron
NR Non Coding
SOMATIC MUTATIONAL LANDSCAPE
VITAMIN D DEFICIENCY AND PROSTATE CANCER DISPARITIES
THE ILLUSION OF INCLUSION IN PROSTATE CANCER CLINICAL TRIALS
FULFILLING THE PROMISE OF PRECISION MEDICINE
Findings
AUTHOR CONTRIBUTIONS
Full Text
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