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Explaining racial differences in prostate cancer in the United States: Sociology or biology?†
Article first published online: 25 JUN 2004
Copyright © 2004 Wiley-Liss, Inc.
Volume 62, Issue 3, pages 243–252, 15 February 2005
How to Cite
Freedland, S. J. and Isaacs, W. B. (2005), Explaining racial differences in prostate cancer in the United States: Sociology or biology?. Prostate, 62: 243–252. doi: 10.1002/pros.20052
- Issue published online: 16 DEC 2004
- Article first published online: 25 JUN 2004
- Manuscript Accepted: 19 DEC 2003
- Manuscript Received: 9 DEC 2003
- National Institute of Health/National Cancer Institute (SPORE grant). Grant Number: P50CA58236
- Department of Defense, Prostate Cancer Research Program. Grant Number: PC030666
- prostate cancer;
Black men in the United States have the highest incidence and mortality from prostate cancer in the world. Even after adjusting for stage at diagnosis, black men have higher mortality rates than white men. Multiple reasons have been postulated to explain these findings including access to care, attitudes about care, socioeconomic and education differences, differences in type and aggressiveness of treatment, dietary, and genetic differences. While each reason may contribute to the higher incidence or higher mortality, likely combinations of reasons will best explain all the findings. Racial differences in socioeconomic status have been well established and we review the significance of these findings in relationship to prostate cancer. Also, with recent advances in the understanding of genetic variation in the human genome, in general, and in the genes involved in pathways relevant to prostate cancer biology, in particular, a number of genes with alleles which differ in frequency between black and white men have been proposed as a genetic cause or contributor to the increased prostate cancer risk in black men. However, the clinical significance of these genetic differences is not fully known. Finally, we conclude with some thoughts as to how to integrate the findings from sociological as well as biological studies and touch upon methods to reduce the disparate burden of prostate cancer among blacks in the United States. © 2004 Wiley-Liss, Inc.