Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa

Abstract

Background: African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade.

Results: Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks.

Conclusion: The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.

Figure 1

Age-adjusted prostate cancer incidence rates comparing UK European, African Caribbean, and South Asian men, age 50 and above, between 1999 and 2000. *Incidence rate is per 100,000. Source: Chinegwundoh F, Enver M, Lee A, Nargund V, Oliver T, Ben-Shlomo Y. Risk and presenting features of prostate cancer amongst African-Caribbean, South Asian and European men in North-east London. BJU International 2006, 98:1216–1220. [24]

Figure 2

Age-adjusted risk ratios for prostate cancer comparing UK European, African Caribbean, and South Asian men, age 50 and above, between 1999 and 2000. *P value < 0.001 for European vs. African Caribbean. †P value = 0.13 for European vs. South Asian. Source: Chinegwundoh F, Enver M, Lee A, Nargund V, Oliver T, Ben-Shlomo Y. Risk and presenting features of prostate cancer amongst African-Caribbean, South Asian and European men in North-east London. BJU International 2006, 98:1216–1220. [24]

Figure 3

Age-adjusted prostate cancer incidence rates comparing UK European, African Caribbean, and South Asian men, age 40 and above, between 1997 and 2001. *Incidence rate is per 100,000. Source: Ben-Shlomo Y, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F et al: The Risk of Prostate Cancer amongst Black Men in the United Kingdom: the Process Cohort Study. Eur Urol 2008, 53:99–105. [25]

Figure 4

Age-adjusted risk ratios for prostate cancer comparing UK Black Caribbean and White men, age 40 and above, between 1997 and 2001. *P value < 0.0001. Source: Ben-Shlomo Y, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F et al: The Risk of Prostate Cancer amongst Black Men in the United Kingdom: the Process Cohort Study. Eur Urol 2008, 53:99–105. [25]

Figure 5

Age-adjusted risk ratios for prostate cancer comparing UK Black African and White men, age 40 and above, between 1997 and 2001. *P value < 0.0001. Source: Ben-Shlomo Y, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F et al: The Risk of Prostate Cancer amongst Black Men in the United Kingdom: the Process Cohort Study. Eur Urol 2008, 53:99–105. [25]

Figure 6

Age-adjusted risk ratios for prostate cancer comparing UK Black African and Black Caribbean men, age 40 and above, between 1997 and 2001. *P value = 0.35. Source: Ben-Shlomo Y, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F et al: The Risk of Prostate Cancer amongst Black Men in the United Kingdom: the Process Cohort Study. Eur Urol 2008, 53:99–105. [25]