Abstract:
Prostate cancer (PCa) is the most common cancer
diagnosis in men from economically stable countries
and is a leading cause of cancer-related
death.1 However, the population with the highest
reported incidence and mortality rates globally
are African Americans. Although the lifetime risk
of a cancer diagnosis (one in two) or cancerassociated
mortality (one in four) is no different
for American men of African or European heritage,
the figures are dramatically skewed for PCa.2 Incidence
and mortality rates are 1.6- and 2.4-fold
greater for African Americans than for European
Americans, respectively.3 Additional clinical parameters
exasperated in African Americans are
higher serum prostate-specific antigen (PSA)
levels population wide and at diagnosis, younger
age at diagnosis, shorter PSA doubling before
surgery, higher tumor grade and volume at surgery,
higher incidence of anteriorally located tumors
(more challenging to obtain a biopsy sample),
and faster growing tumors (greater potential for
metastasis).4-10 Although African American men
have the greatest PCa burden globally, the relationship
to men from Africa is less clear. We present the challenges and largely overlooked
potential to address the impact of PCa within
Africa. We provide commentary from our experiences
as the clinical (M.S.R.B.) and scientific
(V.M.H.) directors of the Southern African Prostate
Cancer Study (SAPCS).
