Dr. Yamoah on Racial Disparities in Prostate Cancer

Kosj Yamoah, MD, a radiation oncologist at Moffit Cancer Center, discusses reasons for understanding the racial disparities in patients with prostate cancer. Yamoah shared this insight during an interview at the 2016 OncLive State of the Science Summit on Genitourinary Cancers.

Yamoah, who has a passion for identifying the disparities in prostate cancer, says that data across the board show that African-American men or men of African descent have a 1.6-fold increase in incidence of prostate cancer. Additionally, they have about a 2.4-fold increase in mortality in prostate cancer. Also, the age that these patients get prostate cancer is a slightly younger age than others.

From looking at these data, there are 2 questions that come up, Yamoah explains. These questions are, why are these men getting prostate cancer more than the average population, and why are they dying from prostate cancer more? Yamoah says it is easier to look at all of this data under more fair access or socioeconomic status. However, when examining the data a little more strongly, it points to a more biologic component of the disease that might not be clear.

Over the last few years, researchers have also identified that prostate cancer is also an increasing problem among men living in Africa and in the Caribbean. This points to a more genomic basis, he adds.

Results of a study presented at the 2015 ASCO Annual Meeting showed that 6 biomarkers—ERG, AMACR, SPINK1, NKX3-1, GOLM1, and androgen receptor—demonstrate a statistically significant differential expression in African-American patients versus European patients.

Other analyses have explored the disparities in prostate cancer. For example, it was found that African Americans, especially those with a Gleason score ≤6, may have an increased risk of seminal vesicle invasion after undergoing radical prostatectomy. This may be a representation of racial differences in the biology of prostate cancer’s disease progression, contributing to poorer outcomes.