Update on prostate cancer in black men

Abstract

Background Carcinoma of the prostate (CaP) is the most common male malignancy worldwide and the highest incidence has been recorded in black men. CaP appears to have a more aggressive biology in this sub-population but the reasons for these observed differences have not been fully elucidated. This article is a review of the current published evidence on the disease in black men. Methods We searched Pubmed and Google for articles on CaP with an emphasis on those focusing on sub-population differences. Published abstracts of presentations at international scientific meetings were also reviewed. Results Molecular studies suggest that black men have a genetic predisposition to the development and/or progression of CaP. Variations in several genes and cellular pathways have been implicated in their increased CaP risk. Clinicopathologic differences include more prevalent and extensive high grade prostatic intraepithelial neoplasia (HGPIN) and higher prostate-specific antigen (PSA) values at initial diagnosis. Sociocultural differences in access and uptake of health care resulting in delayed presentation along with differential care are also thought to contribute to the poorer outcomes associated with prostatic malignancy in black men. Conclusion Considerable evidence exists on the effect of black ethnicity on the molecular and clinical characteristics of CaP. More studies into the racial differences in the incidence and prognosis of CaP are required to provide information about the mechanisms responsible for this observation.