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Prostate Cancer pp 355–376Cite as

Racial Differences in Prostate Cancer Mortality

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Part of the book series: Contemporary Cancer Research ((CCR))

Abstract

African Americans have a higher incidence of, and greater mortality from, prostate cancer than Caucasian Americans, and the reasons for racial disparity remain unclear. The racial differences in participation in prostate cancer early detection programs are narrowing. However, racial differences persist in interaction with the health care system. Many of these differences may be more socioeconomic than racial, but many African Americans lack trust in the American health care system that may be overcome by personal interaction with their health care provider. African Americans more often use alternative medicines and may more frequently decline potentially curative treatments. Racial differences in host and tumor biology are difficult to evaluate. African Americans more often consume higher fat diets and are more often obese, both of which may promote prostate carcinogenesis. Although there is no evidence for higher serum androgen levels in African Americans compared with Caucasian Americans, their prostates may be more sensitive to androgens because of a shortened CAG repeat within the androgen receptor gene. Studies involving hereditary prostate cancer and genetic polymorphisms that may affect prostate cancer risk have frequently not included high numbers of African Americans, and the interpretation of such studies are further complicated by issues regarding population stratification. Although there are no racial differences in prostate-specific antigen (PSA) and its derivatives, there is some evidence that African American prostate cancer may have higher tissue levels of sex hormone-binding globulin (SHBG) and increased androgen receptor protein expression. Although some studies suggest racial differences in growth factors and cell regulatory pathways, these studies require studies of larger numbers of men.

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Authors and Affiliations

  1. Roswell Park Cancer Institute, Buffalo, NY

    James L. Mohler MD

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  1. James L. Mohler MD
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  1. Emory University School of Medicine, Atlanta, GA

    Leland W. K. Chung PhD

  2. Johns Hopkins University School of Medicine, Baltimore, MD

    William B. Isaacs PhD

  3. Prostate Cancer Foundation, Santa Monica, CA

    Jonathan W. Simons MD

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Mohler, J.L. (2007). Racial Differences in Prostate Cancer Mortality. In: Chung, L.W.K., Isaacs, W.B., Simons, J.W. (eds) Prostate Cancer. Contemporary Cancer Research. Humana Press. https://doi.org/10.1007/978-1-59745-224-3_19

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  • DOI: https://doi.org/10.1007/978-1-59745-224-3_19

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