Does the racial-ethnic variation in prostate cancer risk have a hormonal basis?

Abstract

One of the most intriguing features of prostate cancer epidemiology is the marked international and racial-ethnic variation in risk. There is a 30-50-fold difference in risk between African American men, at the highest end of this racial-ethnic spectrum of risk, and native Japanese and Chinese men, at the lowest end of this spectrum. Because of their important growth regulatory effects on prostate cells, there has been widespread interest in the role of androgens in prostate cancer pathogenesis. The authors have been evaluating systematically whether population variations in secretion and metabolism of androgens and/or regulation of androgen activity can explain the marked racial-ethnic diversity in prostate cancer incidence. Differences in hormonal patterns among groups have been demonstrated in a manner predicted by their underlying prostate cancer incidence, and a series of studies have been initiated to determine if genetic control of androgen regulation among racial-ethnic groups also may be important in determining prostate cancer risk. Cancer 1995;75:1778–82.