Prostate cancer among South Asian men in the United Kingdom: A systematic review

Abstract

Introduction: Rates of prostate cancer (PC) vary considerably between ethnic groups worldwide, and migratory studies have demonstrated the importance of both inherent and environmental influences. Healthcare systems also differ significantly worldwide, and comparisons of PC data between the United Kingdom and America have previously shown contradictory conclusions among ethnic groups. The South Asian population (SA) is the most predominant UK ethnic minority group. Aims: To systematically explore and critically analyse the available UK-based evidence regarding PC among SA men. Specifically, to review research that assesses the following factors: PC incidence, disease characteristics, treatment and survival outcomes. Results: The existing evidence suggests that UK SA men have a lower PC incidence and younger age at diagnosis, in comparison with White men in the United Kingdom. Contrasting evidence is presented in studies that separately analyse men originating from India, Pakistan and Bangladesh. There is insufficient and contradictory evidence regarding whether SA men show altered PC disease characteristics or have differential survival rates. The evidence is limited regarding PC treatment; however, this indicates that SA men are less frequently treated surgically compared to White men Conclusion: Further high-quality research is required focusing on accurate ethnicity allocation, analysis of separate SA origin countries, socio-economic adjustment, subgroup analysis of treatment in low-risk PC and identifying the support needs of SA minorities with PC. This will help to ensure that ethnic minorities with PC are appropriately diagnosed, counselled and treated Level of evidence: 3