Genetic Contributions to Prostate Cancer Disparities in Men of West African Descent

Abstract

Prostate cancer (PCa) is the second most frequently diagnosed malignancy and the second leading cause of death in men worldwide, after adjusting for age. According to the International Agency for Research on Cancer, continents such as North America and Europe report higher incidence of PCa; however, mortality rates are highest among men of African ancestry in the western, southern, and central regions of Africa and the Caribbean. The American Cancer Society reports, African Americans (AAs), in the United States, have a 1.7 increased incidence and 2.4 times higher mortality rate, compared to European American's (EAs). Hence, early population history in west Africa and the subsequent African Diaspora may play an important role in understanding the global disproportionate burden of PCa shared among Africans and other men of African descent. Nonetheless, disparities involved in diagnosis, treatment, and survival of PCa patients has also been correlated to socioeconomic status, education and access to healthcare. Although recent studies suggest equal PCa treatments yield equal outcomes among patients, data illuminates an unsettling reality of disparities in treatment and care in both, developed and developing countries, especially for men of African descent. Yet, even after adjusting for the effects of the aforementioned factors; racial disparities in mortality rates remain significant. This suggests that molecular and genomic factors may account for much of PCa disparities.

Keywords: GWAS; Vitamin D; genetics; precision medicine; prostate cancer disparities; prostate cancer genetics; prostate cancer screening; socioeconomic status.

Figure 1

Global prostate cancer incidence and mortality by World Areas. Graph indicates age standardized incidence (Blue) and mortality rates (Orange), per 100,000. Mortality rates were sorted from highest to lowest (12).

Figure 2

Percent of men aged 55-69 years who had a Prostate- Specific Antigen (PSA) test and Observed SEER Incidence Rate (All Ages), Distant, by race/ethnicity, 2005-2018. Orange, Yellow and Green lines represent Black, NHW (non-Hispanic white) and Hispanic incident of distant tumors per 100,000 persons in the U.S, respectively. Burgundy, Brown, and Blue lines represent Black, NHW (non-Hispanic white) and Hispanic PSA testing percent of adults in the U.S. Data adapted from Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2005-2018 and SEER 21 areas estimates for a specific stage at diagnosis (Localized, Regional, Distant or Unknown/Unstaged) (29, 30).