Health Disparities and Inequities in Prostate Cancer Along the Continuum of Care

Prostate cancer remains one of the most commonly diagnosed malignancies worldwide, yet significant disparities and inequities persist across the continuum of care. Black men face a disproportionate burden, exhibiting the highest incidence and mortality rates. Older patients often receive less aggressive treatment despite higher risk profiles. Insurance status critically influences timely diagnosis and treatment; uninsured and underinsured individuals are more likely to experience delays in care, leading to worse prognoses. Rural residents and those with lower-income have limited access to specialized care while those of lower education status have reduced screening and later-stage diagnoses. Disparities extend to biopsy techniques and treatment decisions. Black and other underserved populations are less likely to undergo targeted biopsies, which have been shown to improve tumor characterization and risk stratification. Additionally, they are more likely to receive non-definitive management, even when presenting with high-risk, potentially lethal disease. Socioeconomic barriers, healthcare access, provider biases, and underrepresentation and exclusion from clinical trials further exacerbate these disparities, limiting opportunities for precision medicine approaches tailored to diverse populations. Addressing these inequities requires a multifaceted approach, including increasing access to advanced diagnostics and therapeutics, improving representation in research, and integrating social determinants of health into prostate cancer management strategies. Emerging evidence on radiogenomics and molecular biomarkers offers promising avenues for personalized care, but equitable implementation is crucial to avoid widening existing gaps. A concerted effort to eliminate disparities is essential to achieving equitable prostate cancer outcomes across all populations.