Why do African-American men face higher risks for lethal prostate cancer?

Area of Science:

• Oncology
• Genetics
• Health Disparities

Background:

• African-American men experience higher prostate cancer (PCa) incidence and mortality rates in the USA.
• The reasons for these disparities have been debated, involving tumor biology and socioeconomic factors.

Purpose of the Study:

• To investigate the multifactorial reasons behind the higher risk of lethal PCa in African-American men compared to Non-Hispanic White (NHW) men.
• To examine differences in tumor biology and socioeconomic factors contributing to PCa outcomes.
• To establish a management consensus to reduce PCa outcome disparities.

Main Methods:

• Review of recent evidence (past 2 years) on PCa tumor biology and socioeconomic factors.
• Analysis of genomic and transcriptome profiling data.
• Evaluation of epidemiological evidence regarding healthcare access and PCa outcomes.

Main Results:

• African-American men show upregulated inflammatory pathways and downregulated DNA repair genes.
• NHW men exhibit higher DNA repair, glycolysis, and cell cycle pathway activity.
• Equal healthcare access suggests PCa is not inherently more lethal in African-American men, but tumor biology differences persist, potentially explaining treatment response variations.

Conclusions:

• Prostate cancer in African-American and NHW men may present with distinct ancestral disease characteristics.
• Personalized PCa treatment approaches are warranted.
• Translational research is essential to uncover genetic differences and develop individualized therapeutic strategies.