

Black men in England have twice the lifetime risk of both being diagnosed with – and dying from – prostate cancer compared with white men, according to a study by Public Health England and Prostate Cancer UK.

The research, published in the online journal BMC Medicine on Thursday, also found that Asian men have about half the lifetime risk of being diagnosed with, and dying from, prostate cancer compared with white men in England.

It estimates the lifetime risk for black men of dying of prostate cancer at approximately one in 12. The risk for white men is estimated to be about one in 24 and one in 44 for Asian men.

Prostate cancer is the most common cancer in men in the UK, with 41,736 cases diagnosed in 2011, and is predicted to become the overall most commonly diagnosed cancer by 2030.

The researchers, who did not attempt to find out why the differences exist between ethnic groups, suggest that their findings make a case for considering targeted prostate cancer screening of black men.



The lead author, Alison Cooper, from Prostate Cancer UK, said: “We already knew that black men were more likely to be diagnosed with prostate cancer than white men. However, the data we had was fast becoming out of date. The study also provides important absolute-risk figures to help black men better understand their risk of developing prostate cancer. These figures can be used for targeted awareness-raising and to help them make an informed decision about whether or not to have a prostate specific antigen (PSA) test.”

A PSA is the most common initial test for men concerned about prostate cancer but there are issues with its accuracy and there can be potentially harmful consequences, which is why there is currently no national screening programme for the disease.

The researchers examined a sample, from various official sources, of 25.6 million men, including 102,252 prostate cancer diagnoses and 26,521 deaths due to prostate cancer.

They estimated that the lifetime risk of being diagnosed with prostate cancer in England is approximately one in eight for white men, one in four for black men and one in 13 for Asian men. The study did not look at risk for men of mixed ethnicity.

They found that white, black and Asian men diagnosed with prostate cancer all have a one-third chance of dying from the disease, independent of their ethnicity. There have been previous suggestions that the higher risk among black men may be linked to genetics.

“This could be interpreted as an indication that the disease is no more aggressive in any one ethnic group and/or that there is no bias in detection or treatment between ethnic groups,” the authors write. “Nonetheless, proportionally more black men are dying from prostate cancer in England.”

Aside from ethnicity, the main risk factors linked to the disease are age, family history of prostate cancer and body weight.

Prof Julia Verne, co-author and clinical lead at Public Heath England, said: “The findings follow similar statistics from the USA and highlight the importance of raising awareness among the black African-Caribbean community in England but also, the need for further research into the disease.

“It is important that men, from all communities, are aware of symptoms that are associated with prostate cancer. These include the need to urinate often, especially at night, and straining to urinate or taking a long time to finish. Our message is: do not delay, if you are experiencing any symptoms or suffering from any discomfort, do go and see your GP.”

Cancer Research UK scientists have for the first time identified that there are five distinct types of prostate cancer and found a way to distinguish between them, according to a landmark study.

The authors of the paper, published in EBioMedicine on Thursday, believe the findings could enable identification of tumours that are more likely to grow and spread aggressively through the body.

They studied samples of healthy and cancerous prostate tissue from more than 250 men, looking for abnormal chromosomes and measuring the activity of 100 different genes linked to the disease.

One of the study’s authors, Dr Alastair Lamb, from the Cancer Research UK Cambridge Institute, said: “The next step is to confirm these results in bigger studies and drill down into the molecular ‘nuts and bolts’ of each specific prostate cancer type. By carrying out more research into how the different diseases behave we might be able to develop more effective ways to treat prostate cancer patients in the future, saving more lives.”