An historic conference titled “A Leadership Conference—Prostate Cancer in the African-American Community: An Agenda for Action” was held November 20 to 22, 1997, in Houston, Texas. The meeting—which was a collaborative effort of the American Cancer Society, the Centers for Disease Control and Prevention, and the National Cancer Institute—examined the unique challenge that prostate cancer poses to the African-American community.
Among the relevant research findings (and the investigators responsible for the findings) were the following:
1. Tracking disease patterns by “race” is inherently difficult because of multiple confounders, such as socioeconomic status and lifestyle choices. Susceptibility to disease can be studied more rigorously using specific allelic domains as opposed to broad racial and genetic hypotheses. (Richard S. Cooper, MD, and Vincent L. Freeman, MD, Loyola University, Stritch School of Medicine, Marywood, IL.)
2. Young African-American men may have increased exposure to elevated levels of androgens. Evidence exists for genetic differences among men of differing races that could correlate with variations in prostate cancer incidence and aggressiveness. (Curtis A. Pettaway, MD, University of Texas M.D. Anderson Cancer Center, Houston, TX.)
3. Early detection tests generally identify clinically significant prostate cancers and have greatly reduced the number of men initially diagnosed with advanced disease. Some evidence suggests that the recent small decline in prostate cancer mortality may be, in part, the result of early detection; however, corroborative studies have not yet been completed. (Robert A. Smith, PhD, and Harmon J. Eyre, MD, American Cancer Society, Atlanta, GA.)
4. African-American women significantly influence health-related behaviors of African-American men. Preliminary data also suggest that African Americans are more likely to carry the genes associated with prostate cancer diagnosis at an earlier age. African-American males also may be at higher risk because of high dietary fat and low levels of lycopene compared with other groups. (Isaac J. Powell, MD, Wayne State University, Detroit, MI.)
During the conference, the American Cancer Society confirmed its commitment to earmark 10% of its annual $80 million research budget for prostate cancer. A National Blueprint for Action was developed and is included in this article. A follow-up news conference announcing the Leadership Conference's findings and recommendations was held in January 1998.