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Prostate Cancer
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Prostate Cancer Information: Race and Risk

The Unites States has the highest incidence of prostate cancer in the world and over 230,000 men are diagnosed each year.  African-American men have the highest incidence rate as well as the highest mortality rates associated with prostate cancer, followed consecutively by Caucasians, Hispanics, Asians and Pacific Islanders, then American Indians and Alaska Natives.

African-American Men and Prostate Cancer
Black American men have the highest risk of prostate cancer in the United States. They also have the highest risk of developing aggressive prostate cancer and also have the highest prostate cancer mortality rates.

There are two predominant theories as to why African-American men have a higher risk of prostate cancer: genetics and healthcare access. Some doctors believe that genetics play an important role; others believe that limited access to quality healthcare is to blame. A third theory exists: some doctors believe that a traditional diet which is high in saturated fat causes the higher prostate cancer risk. However, the diets of many Americans, regardless of race, have higher levels of fat than the diets of men of any other nationality.

The most widely-accepted theory of increased prostate cancer risk in African-Americans is an amalgamation of the first and second theories. Genetics (due to melanin levels in the skin) may predispose African-American men, while limited access to quality healthcare does not catch the disease in earlier stages and does not get these men the best possible treatment.

What Do African-American Genes have to do with Prostate Cancer?
One of the most widely accepted theories is that black men living in North America do not get the exposure to ultraviolet (UV) light sufficient for the synthesis of Vitamin D. Adequate levels of Vitamin D seem to have a protective effect against cancer. Since Vitamin D production is somewhat inhibited through higher levels of melanin, black men living in areas of limited sunlight (such as in the north) may not produce sufficient Vitamin D.

What about Healthcare Quality and Prostate Cancer?
Many doctors also feel that the higher mortality rates associated with prostate cancer in black men, however, are related to unequal access to adequate healthcare. Whether it’s due to inadequate health insurance, complete lack of health insurance, neglecting proper diagnostic testing and regular medical checkups, or other factors, more black men die from prostate cancer. African-American men, regardless of family history, should begin PSA testing at the age of 40.

What About the Groups with Lower Prostate Cancer Risk?
After black men, white men living in America have the next highest risk. Some European ethnic groups, such as Greeks and Italians, have lower risks of prostate cancer until the second or third American-born generations. The increase is most commonly attributed to the adoption of American-style diets which focus on meat and saturated fats rather than vegetables, whole grains, and olive oil.

Asian ethnic groups, particularly the Japanese, have extremely low prostate cancer rates. Asian countries, which have typically been low risk countries, however, are increasing in incidence rates. Some researchers attribute the elevated national risks to the rising levels of obesity due to the increased consumption of fatty foods and red meat.

While race may increase risk, many researchers believe that diet also plays an equally, if not more important, role.




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