title: Racial Differences in the Diagnosis and Treatment of Prostate Cancer.
abstract: Disparities between African American and Caucasian men in prostate cancer (PCa) diagnosis and treatment in the United States have been well established, with significant racial disparities documented at all stages of PCa management, from differences in the type of treatment offered to progression-free survival or death. These disparities appear to be complex in nature, involving biological determinants as well as socioeconomic and cultural aspects. We present a review of the literature on racial disparities in the diagnosis of PCa, treatment, survival, and genetic susceptibility. Significant differences were found among African Americans and whites in the incidence and mortality rates; namely, African Americans are diagnosed with PCa at younger ages than whites and usually with more advanced stages of the disease, and also undergo prostate-specific antigen testing less frequently. However, the determinants of the high rate of incidence and aggressiveness of PCa in African Americans remain unresolved. This pattern can be attributed to socioeconomic status, detection occurring at advanced stages of the disease, biological aggressiveness, family history, and differences in genetic susceptibility. Another risk factor for PCa is obesity. We found many discrepancies regarding treatment, including a tendency for more African American patients to be in watchful waiting than whites. Many factors are responsible for the higher incidence and mortality rates in African Americans. Better screening, improved access to health insurance and clinics, and more homogeneous forms of treatment will contribute to the reduction of disparities between African Americans and white men in PCa incidence and mortality.
authors.affiliation: Department of Pharmacy, Federal University of Sergipe, Brazil.
authors.forename: Giuliano Di
authors.identifier: 0000-0001-9753-222X
authors.initials: GD
authors.lastname: Pietro
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Ganna
authors.identifier: 0000-0002-2214-4086
authors.initials: G
authors.lastname: Chornokur
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Nagi B
authors.identifier: 0000-0002-6121-2627
authors.initials: NB
authors.lastname: Kumar
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Chemar
authors.identifier: 0000-0002-3809-4570
authors.initials: C
authors.lastname: Davis
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Jong Y
authors.identifier: 0000-0002-6384-6447
authors.initials: JY
authors.lastname: Park
keywords: African Americans; Healthcare disparities; Prostatic neoplasms