The largest US cancer health disparity exists in prostate cancer, with Black men having more than a two-fold increased risk of dying from prostate cancer compared to all other races. This disparity is a result of a complex network of factors including socioeconomic status (SES), environmental exposures, and genetics/biology. Inequity in the US healthcare system has emerged as a major driver of disparity in prostate cancer outcomes and has raised concerns that the actual incidence rates may be higher than current estimates. However, emerging studies argue that equalizing healthcare access will not fully eliminate racial health disparities and highlight the important role of biology. Significant differences have been observed in prostate cancer biology between various ancestral groups that may contribute to prostate cancer health disparities. These differences include enhanced androgen receptor signaling, increased genomic instability, metabolic dysregulation, and enhanced inflammatory and cytokine signaling. Immediate actions are needed to increase the establishment of adequate infrastructure and multi-center, interdisciplinary research to bridge the gap between social and biological determinants of prostate cancer health disparities.
Cancer letters. 2022 Feb 02 [Epub ahead of print]
Dallin Lowder, Kinza Rizwan, Collin McColl, Alyssa Paparella, Michael Ittmann, Nicholas Mitsiades, Salma Kaochar
Department of Medicine, Baylor College of Medicine, Houston, TX, USA., Department of Pathology, Baylor College of Medicine, Houston, TX, USA; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA., Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA., Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA. Electronic address: .