Risk for prostate cancer among black males in England


A newly published article in the British Medical Journal has shown that black males in England are twice as likely to be diagnosed with prostate cancer as white males, and are twice as likely to die of prostate cancer too.

These data are analogous — but not exactly the same as — data in the USA, where black males are about 1.6 times more likely than whites to be diagnosed with prostate cancer and about 2.3 times more likely to die of this disease.

The new study by Lloyd et al. looked at English data for the years 2008 to 2010, categorized by ethnic origin.

  • White males were those who self-categorized as “white British,” “white Irish,” and “other white”.
  • Black males included those who self-categorized as “black African,” “black Caribbean,” and “other black”.
  • Asian males included those who self-categorized as “Indian,” “Pakistani,” “Bangladeshi,” and “other Asian”.

What Lloyd et al. were able to show was that the lifetime risk of being diagnosed with prostate cancer in England is

  • 13.3 percent (i.e., about 1 in 8) for white males (range, 13.2 to 15.0 percent)
  • 29.3 percent (i.e., about 1 in 4) for black males (range, 23.5 to 37.2 percent)
  • 7.9 percent (i.e., about 1 in 13) for Asian males (range, 6.3 to 10.5  percent)

Similarly, the lifetime risk of dying from prostate cancer in England is

  • 4.2 percent (i.e., about 1 in 24) for white males (range, 4.2 to 4.7 percent)
  • 8.7 percent (i.e., about 1 in 12 for black males (range, 7.6 to 10.6 percent)
  • 2.3 percent (i.e., about 1 in 44) for Asian males (range, 1.9 to 3.0 percent)

This is the first time such data have been available for male residents of England, and so it is interesting to see that the white/black discrepancy is similar to that in the USA. The much lower risk level among the Anglo-Asian population is also interesting, but US readers need to be aware that the make-up of the “Asian” population in England is very different to that of the “Asian” population in the USA, where there is a far higher occurrence of people of ethnic Chinese and Japanese origin compared to the UK, and a relatively lower occurrence of persons of Indian, Pakistani, and Bangladeshi origin.

What the study does not do is tell us anything at all about why this discrepancy in incidence and mortality exists.

 

One Response

  1. Yes, very interesting. When I have seen US studies on this I think there has been some suggestion that access to good healthcare may be different in the US among different ethnic groups, and in particular the black population has proportionately less medical insurance.

    Here in the UK, with our National Health Service, there is virtually no difference in access to medical care. Of course, men are traditionally reluctant to consult the doctor, and it’s possible there are ethnic differences there.

    Nevertheless, this very marked difference between the races in incidence and outcome needs explaining, and could be very revealing.

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