Study to Examine Link Between Black Men and Prostate Cancer

To understand why Black men are disproportionately diagnosed with prostate cancer, a $26.5 million federally funded study has been launched to examine the disparity.

The study — named RESPOND, or Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Tumor Markers, and Social Stress — is supported by the National Cancer Institute (NCI) and the National Institute on Minority Health and Health Disparities (NIMHD), both parts of the National Institutes of Health, as well as by the Prostate Cancer Foundation (PCF).

The NCI funding will be provided by the 21st Century Cures Cancer Moonshot Initiative.

The importance of annual prostate exams, particularly for Black men, was recently magnified by the death of former Congressman Ron Dellums from prostate cancer, as well as presiding Episcopal Bishop Michael Curry’s announcement that he was diagnosed with the disease.

Prostate cancer deaths by race (Courtesy of National Cancer Institute)
Prostate cancer deaths by race (Courtesy of National Cancer Institute)

African-American men have about a 15 percent chance of developing prostate cancer in their lifetimes, compared to about a 10 percent chance for White men. Further, African-American men are more likely to be diagnosed with an aggressive form of the disease.

The risk of dying from prostate cancer for African-American men is about four percent, compared to about two percent for White men.

Incidence of prostate cancer, by race and ethnicity (Courtesy of National Cancer Institute)
Incidence of prostate cancer, by race and ethnicity (Courtesy of National Cancer Institute)

With the study, researchers aim to learn more about why such disparities exist.

The five-year study designed to better explore why Black men disproportionately experience aggressive prostate cancer, that is, disease that grows and spreads quickly, compared with men of other racial and ethnic groups. The study will include 10,000 Black men with prostate cancer to evaluate the genetic molecular side, as well as the social, environmental and behavioral aspects.

Experts say because prostate cancer is a chronic disease that lingers for long periods of time, it lends itself to this type of study for figuring out the right buttons to push.

“We’ve known that the way prostate cancer manifests in Black men is that a higher proportion have the more aggressive form of the disease earlier in life,” said Eliseo Perez-Stable, director at the National Institute of Minority Health and Health Disparities. “Yet we have not developed the tools from a clinical perspective to say we should use race as a characteristic to decide on what treatment to administer.”

The study allows investigators to examine possible associations between this aggressive disease and exposure to neighborhood or environmental stressors such as discrimination, early-life adversity, and segregation. They will also study DNA and tumor samples to identify gene variants associated with aggressive prostate cancer.

Once researchers have identified genetic changes associated with aggressive prostate cancer, they will investigate how the social environment interacts with those genetic changes.

African-American men will be recruited through seven specific cancer registries in Detroit, California, New Jersey, Georgia, Louisiana, Texas and Florida. Researchers will contact men in these cancer registries and invite them to participate.

“These seven registries were chosen because of the high number of African American men in these locations,” said Dr. Damali Martin, program director at the National Cancer Institute.

Martin ensured beyond the seven targeted registries, any African-American males who have been diagnosed with prostate cancer can be considered for the study.

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