Prostate Cancer Racial Disparities: A Systematic Review by the Prostate Cancer Foundation Panel

Area of Science:

• Oncology
• Health Disparities Research
• Genetics

Background:

• Prostate cancer (PCa) disproportionately affects Black men in the USA.
• Structural factors contribute to heterogeneous patient outcomes and population-level disparities.
• Understanding the drivers of PCa disparities across the disease continuum is crucial.

Purpose of the Study:

• To synthesize evidence on PCa disparities from a population-level perspective.
• To compare PCa data from the USA with "equal access and equal care" settings.
• To provide a consensus summary of the current state of PCa disparities.

Main Methods:

• Systematic literature review using PRISMA guidelines.
• Analysis of 3333 publications (2011-2021), with 52 included in the review.
• Inclusion of 13 additional articles on guidelines, trials, and statistical methods.

Main Results:

• PCa disparities stem from socioeconomic factors affecting care access and genetic factors influencing tumor biology.
• Black men in the USA exhibit a 1.8x higher PCa incidence rate than White men.
• Failure to account for race-specific incidence perpetuates disparities and increases long-term mortality.

Conclusions:

• Racially diverse studies, including precision -omics and targeted therapies, are essential.
• Novel approaches like mediation analysis and genetic ancestry are needed to understand PCa genomic diversity and behavior.
• Prioritizing inclusion of Black men in intervention studies and clinical trials is vital to reduce PCa disparities.