The relative aggressiveness of prostate cancer in black and white patients


A newly published article, available on-line in the journal Prostate Cancer and Prostatic Diseases, shows that tissues from prostate biopsies from black men express higher levels of biomarkers for aggressive disease than do tissues from prostate biopsies taken from white men.

Kim et al. set out to compare the expression of a small panel of investigational biomarkers as a function of race in a cohort of 131 men undergoing radical prostatectomy for localized prostate cancer. All prostate biopsy specimens were collected at the Durham Veterans Affairs Medical Center in Durham, North Carolina. They were all appropriately stained and assayed for levels of α-methylacyl CoA racemase (AMACR), androgen receptor (AR) and Ki67 (which are just three of the many different biomarkers currently under investigation for their potential in the management of prostate cancer).

Using the available data, it was possible to identify six different feature combinations that had already been shown to be significantly associated with prostate cancer progression in a previously published study.

The core results of the study showed that:

  • On univariate analysis, all six biomarker features were expressed at higher levels in black men than in white men.
    • Expression levels of Norm AR (P = 0.006) and Ki67 (P = 0.02) were significantly higher in black men than in white men.
  • On multivariate analysis, all six markers were still expressed at higher levels in black men than in white men.
    • Expression levels of Norm AR (P = 0.001), Ki67 (P = 0.007), and Ki67/lum (P = 0.022) were significantly higher in black men than in white men.

The authors conclude that their data support the hypothesis that prostate cancer may be more biologically aggressive among black males than it is among whites. However, we still have no good explanation for this apparent increase in risk of prostate cancer among the black male community.

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