Prostate cancer risk greatest in African American men

Left to right- Rev. A.A. Motley, Dexter King, Rev. Floyd H. Flake and Isaac Newton Farris Jr. join in singing, “We Shall Overcome” during a 2006 service marking the national holiday for Martin Luther King Jr. in Atlanta. Dexter King has died of prostate cancer at the age of 62, it was announced Monday. (JOHN SPINK/AJC staff)

By Donovan J. Thomas

News that the Rev. Martin Luther King Jr.’s son, Dexter King, had died of prostate cancer at age 62 shook Atlanta Monday.

According to the Centers for Disease Control and Prevention, all men are at risk for prostate cancer, but older men, African American men and those with a family history of prostate cancer have a greater risk.

The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer. According to the American Cancer Society, about 1 in 8 men will be diagnosed with prostate cancer during their lifetime. But each man’s risk of prostate cancer varies based on age, race or ethnicity, and other factors.

African American men are more likely to get prostate cancer than other races and ethnicities and are more than twice as likely to die from it than other men. In 2020, out of every 100,000 white men, 95 were diagnosed with a new case of prostate cancer, while out of 100,000 Black (non-Hispanic) men, 154 were diagnosed, according to the U.S. Cancer Statistics Working Group.

For Dr. John Stewart, chief of surgery for Morehouse School of Medicine at Grady Health System, raising awareness about prostate cancer is paramount to improving outcomes.

“We’ve got to make sure to get the word out about prostate cancer screenings,” Stewart said. “As Black men, we aren’t exactly fond of interactions with the medical system. We see it in prostate cancer, we see it in colonoscopy screenings. We have to create a better agenda for men’s health in our community.”

It’s not clear what makes Black men more likely to be diagnosed with prostate cancer, but they also account for a high proportion of advanced cases of the disease, regardless of age, Stewart said.

While 62 is relatively young to most, it is not an unusual age for patients to die from the disease, Stewart said. Also, many people are diagnosed in their 50s or 60s, but may live 10 to 15 years after a diagnosis.

Dr. Wayne Harris, an associate professor in Emory School of Medicine’s department of hematology and medical oncology and an oncologist at Winship Cancer Institute, said that prostate cancer tends to be a disease of older men, but this isn’t always true for Black men.

“In the African American community, it [prostate cancer] is known to have an earlier onset and have a more aggressive profile for reasons that are not fully clear,” Harris said. “There’s this broad spectrum of contributing factors, but not one specific thing that says this is why there are disparities.”

For detecting prostate cancer, the prostate-specific antigen (PSA) blood test is used, but the ACS notes it’s not a perfect test for finding prostate cancer early. It misses some cancers, and sometimes it finds cancers that are so slow-growing they would probably never need to be treated.

The American Cancer Society recommends Black men ask about PSA screenings at 45. This recommendation is five years earlier than other groups.

Harris noted contrasting recommendations by different organizations regarding the PSA screening, stating, “The consensus is that there should be an individualized discussion with the patient’s physician,” for every case to ensure age-appropriate health screenings are conducted. Along with PSA screenings, digital rectal exams can detect prostate cancer, rectal cancer and other abnormalities.

While some risk factors for the cancer can’t be controlled, Harris said that avoiding smoking, using alcohol in excess, a high fat diet and other lifestyle factors are beneficial for not only prostate, but many different types of cancer.

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