Black men in U.S. face significantly higher prostate cancer incidence, related mortality
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Black men have the highest rates of prostate cancer incidence and related mortality compared with all other racial and ethnic groups among U.S.-based men, results of an analysis published in European Urology showed.
Specifically, Black men had a 68% higher incidence of prostate cancer and 111% higher death rate related to prostate cancer than white men, who had the second highest rates for both among the groups studied.
Investigators also found regional disparities, with the highest incidence of prostate cancer observed in Northern and some Southeastern regions and the highest prostate cancer-related death rates in Western regions.
“These data are a call to arms,” Karen E. Knudsen, MBA, PhD, CEO of American Cancer Society and senior author of the study, said in a press release. “Prostate cancer can be readily treated and eradicated when detected in early stage, yet this cancer type persists as the second leading cause of cancer death among men in the United States.”
Trends in the analysis showed a “deeply concerning shift” of later-stage prostate cancer diagnosis among men in the U.S., Knudsen said.
“We can and must do more,” she added.
Background
Previous studies have examined incidence and mortality trends for individual genitourinary cancer types, but none has used a comprehensive approach to investigate possible socioeconomic disparities across all major cancer types within the subspecialty, the researchers noted.
Knudsen and colleagues therefore conducted a cross-sectional analysis to reveal any disparities or trends in incidence and mortality for the most common genitourinary cancer types among patients in the United States, including bladder, kidney, prostate and testicular cancer.
Methodology
The researchers used cancer incidence data (2015-2019) from NCI’s SEER database and the U.S. Cancer Statistics database and mortality data (2016-2020) from the National Center for Health Statistics to determine cross-sectional and temporal trends in cancer incidence and cancer-related death rates according to sex, race/ethnicity and county of residence.
Age-adjusted incidence and death rates served as the study’s primary outcome measurements.
Key findings
Significantly higher prostate cancer related morality occurred among Black men (37.5%; 95% CI, 37-38) compared with white men (17.8%; 95% CI, 17.7-17.9) tracked during the study period (rate ratio = 2.11; 95% CI, 2.08-2.14).
The investigators reported similar prostate cancer incidence patterns from 2000 to 2019 across all racial and ethnic groups that saw rates increase after a sharp decline between the late 2000s and early 2010s.
They did note considerable variation in stage at diagnosis, especially for Black men, among whom rates of localized disease increased between the late 2000s and early 2010s in contrast with other ethnic groups, which showed sharp declines in locally diagnosed disease over the same period.
The most recent 5-year period examined (2015-2019) showed a 4% to 6% increase in regional- and distant-stage prostate cancer diagnoses across all ethnic/minority groups. However, declines in prostate cancer-related death rates slowed among Black and Hispanic men and came to a halt among white and non-Hispanic white patients.
The investigators additionally observed incidence and mortality rates for bladder and kidney cancer two to four times higher for men compared with women over the study period.
The highest prostate cancer death rates occurred among men located in Western counties in the U.S., with the highest incidence rates in the North and parts of the Southeast.
Investigators noted the highest kidney cancer rates among patients located in the Appalachia region, whereas the highest bladder cancer rates occurred among those located in the Northeast for non-Hispanic white patients.
Clinical implications
“This study reveals striking geographic and racial disparities that should be studied and mitigated,” Knudsen said. “Our data identify a significant burden on a subset of populations, including men in the West and Black men overall.”
References :
- American Cancer Society. New study shows Western region has highest prostate cancer mortality among white men in U.S.; Black men face highest prostate cancer mortality overall (press release). Available at: pressroom.cancer.org/ProstateCancerMortality. Published Dec. 21, 2022. Accessed Jan. 4, 2023.
- Schafer EF, et al. Eur Urol. 2022;doi:10.1016/j.eururo.2022.11.023.
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