Publication Date
4-10-2022
Journal
Cancer Letters
DOI
10.1016/j.canlet.2022.01.028
PMID
35122875
PMCID
PMC9701576
PubMedCentral® Posted Date
11-27-2022
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Black or African American, Genomics, Health Status Disparities, Healthcare Disparities, Humans, Male, Prostatic Neoplasms, Socioeconomic Factors, White People, African American, Outcomes, Androgen, DNA Damage, Inflammation, Tumor microenvironment, Social determinants
Abstract
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 ancestral groups that may contribute to prostate cancer health disparities. Notably, relative to White men, Black men with prostate cancer exhibit increased androgen receptor signaling, genomic instability, metabolic dysregulation, and inflammatory and cytokine signaling. Immediate actions are needed to increase multi-center, interdisciplinary research to bridge the gap between social and biological determinants of prostate cancer health disparities.