The Unites States has the highest incidence of prostate cancer in the world and over 230,000 men are diagnosed each year. African-American men have
the highest incidence rate as well as the highest mortality
rates associated with prostate cancer, followed consecutively
by Caucasians, Hispanics, Asians and Pacific Islanders,
then American Indians and Alaska Natives.
African-American Men and
Black American men have the highest risk of prostate
cancer in the United States. They also have the highest
risk of developing aggressive prostate cancer and also
have the highest prostate cancer mortality rates.
There are two predominant theories
as to why African-American men have a higher risk of
prostate cancer: genetics and healthcare access. Some
doctors believe that genetics play an important role;
others believe that limited access to quality healthcare
is to blame. A third theory exists: some doctors believe
that a traditional diet which is high in saturated fat
causes the higher prostate cancer risk. However, the
diets of many Americans, regardless of race, have higher
levels of fat than the diets of men of any other nationality.
The most widely-accepted theory of increased prostate cancer risk in African-Americans is an amalgamation of the first and second theories.
Genetics (due to melanin levels in the skin) may predispose
African-American men, while limited access to quality
healthcare does not catch the disease in earlier stages
and does not get these men the best possible treatment.
What Do African-American
Genes have to do with Prostate Cancer?
One of the most widely accepted theories is that black
men living in North America do not get the exposure
to ultraviolet (UV) light sufficient for the synthesis
of Vitamin D. Adequate levels of Vitamin D seem to have
a protective effect against cancer. Since Vitamin D production is somewhat inhibited through higher levels of melanin, black men living in areas of limited sunlight (such as in the north) may not produce sufficient Vitamin D.
What about Healthcare Quality
and Prostate Cancer?
Many doctors also feel that the higher mortality rates
associated with prostate cancer in black men, however,
are related to unequal access to adequate healthcare.
Whether it’s due to inadequate health insurance, complete lack of health insurance, neglecting proper diagnostic testing and regular medical checkups, or other factors, more black men
die from prostate cancer. African-American men, regardless of family history, should begin PSA testing at the age of 40.
What About the Groups with
Lower Prostate Cancer Risk?
After black men, white men living in America have the
next highest risk. Some European ethnic groups, such
as Greeks and Italians, have lower risks of prostate
cancer until the second or third American-born generations.
The increase is most commonly attributed to the adoption
of American-style diets which focus on meat and saturated
fats rather than vegetables, whole grains, and olive
Asian ethnic groups, particularly
the Japanese, have extremely low prostate cancer rates.
Asian countries, which have typically been low risk
countries, however, are increasing in incidence rates.
Some researchers attribute the elevated national risks
to the rising levels of obesity due to the increased
consumption of fatty foods and red meat.
While race may increase risk, many researchers believe that diet also plays an equally, if not more important, role.