Prostate cancer is the most common cancer in American men and African American men have the highest rate of prostate cancer in the world, with incidence rates and mortality rates twice that of Caucasian men.
Genetics
“Why do African American men have a higher incidence of prostate cancer?” Some have proposed that it may be a function of genetic or hereditary factors. African American men have been shown to have significantly higher levels of testosterone compared to Caucasian men. Because prostate cancer is stimulated by testosterone production, this higher level of testosterone in African American men may lead to a higher incidence of prostate cancer.
However, factors other than hereditary factors may also contribute to the higher rates and more aggressive forms of prostate cancer observed in African American males. There may be common environmental exposures that lead to higher rates of prostate cancer.
More aggressive form of the disease
Not only do African American men tend to have an increased incidence in prostate cancer, African American men also tend to have more aggressive disease at the time of their diagnosis, which may play some part in the disparity in increased mortality rates from prostate cancer in African Americans.
However, it is unknown whether the higher mortality rates of prostate cancer observed in Black males is due to the more aggressive forms of the cancer itself occurring more often in African American males, or the fact that African American men have historically been those less likely to be screened for the early detection of prostate cancer and therefore have more advanced prostate cancer at diagnosis due to delayed presentation.
Currently there is no proven way in which to prevent prostate cancer; however, based upon certain observations some suggest that risk reduction for developing prostate cancer may be possible.
Diet & Nutrition
As discussed, the rate of prostate cancer is highest in the United States, and the incidence of prostate cancer is increasing in other countries where Western diets and lifestyles have been adopted, suggesting that nutritional factors may contribute to prostate carcinogenesis. Specifically, culture and race-specific differences in dietary intake and nutritional factors may play an important role in prostate cancer risk in certain racial minorities. With the observations that obesity and high fat diets are more prevalent among African-American populations, these data support the linkage between diet and cancer risk.
A nutritional factor related to prostate cancer risk is vitamin D deficiency. Vitamin D deficiency is more common in African Americans compared to Caucasians and is believed to be due to deficient nutritional intake (i.e., due to lactose intolerance in many African Americans) as well as to the fact that increased skin pigmentation decreases vitamin D production in the skin in African Americans.
It has thus been suggested that lower levels of vitamin D could contribute to the elevated rates of prostate cancer in African Americans. Low fat diets and vitamin D supplementation may lead to risk reduction of prostate cancer in African American males.
Visit the BlackDoctor.org Prostate Cancer center for more articles.
Follow Dr. Modlin @CharlesModlinMD.
