Prostate Cancer in Black Men of African Descent

I continue to search the medical literature for interesting or important articles about prostate cancer. Here is an abstract. I have made some text bold for emphasis.

Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa
Infect Agent Cancer. 2009; 4(Suppl 1): S2.
Published online 2009 February 10. doi: 10.1186/1750-9378-4-S1-S2.
Folakemi T Odedina,corresponding author1 Titilola O Akinremi,#2 Frank Chinegwundoh,#3 Robin Roberts,#4 Daohai Yu,#1 R Renee Reams,#5 Matthew L Freedman,#6 Brian Rivers,#1 B Lee Green,#1 and Nagi Kumar1

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Background
African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade.

Results
Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks.

Conclusion
The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.

Introduction
In the United States (US), an estimated 30,870 cases of prostate cancer are expected to occur among African American men in 2007, accounting for 37% of all cancers diagnosed in African American men [1]. Between 2000 and 2003, the average annual prostate cancer rate was 60% higher in African American men compared to White men [1]. In addition, African American men have the highest mortality rate compared to any other racial or ethnic group in the US, and 2.4 times higher than in White men. Although prostate cancer incidence and mortality rates have been declining in both African American and White men since 1991, possibly due to improved diagnostic techniques, better screening and improved surgical and radiologic treatments, the rates remain comparably higher among African American men. Why does this disparity continue to exist among African American men in spite of the significant research to eliminate this disparity?
The population-based studies on prostate cancer disparity have traditionally studied African American men only or compared African American men to other racial groups within the US. Although these studies have provided vital insights necessary to understanding the primary differences among the ethnic groups in the US, we are left with more questions than answers. With the problem of prostate cancer disparity persisting, it is crucial that we begin to use new paradigms to examine the problem of prostate cancer disparity from new perspectives. The prospect for a new paradigm/new perspectives emerge with the growing literature on the disproportionate burden of prostate cancer among other Black men (in other parts of the world, other than the US) who are related to African American men through the Transatlantic Slave Trade (TAS) [2-7], especially Black men of West African ancestry. Based on the World Health Organization (WHO)'s worldwide cancer data, West African men have much lower prostate cancer incidence and mortality compared to African American men. For example, compared to Nigerian men, African-American men are >10 times likely to develop prostate cancer and 3.5 times likely to die from the disease [8]. On the other hand, Silverberg and Lubera [9] reported high rates of prostate cancer mortality in Martinique, Trinidad & Tobago; while Glover et al. [10]reported high rates of prostate cancer incidence in the predominantly Afro-Caribbean population of Jamaica. Thus the variability in risk and mortality across these populations of West African descent suggests a potential and important influence of environmental/lifestyle factors acting on prostate cancer risk in these already susceptible populations. Can this evolving international data hold the key to our better understanding of the etiology of unequal burden of this disease in African American men?

The Transatlantic Slave Trade (TAS) Relations
Based on the TAS, about 15 million people were transported as slaves from Africa, not counting those who died en-route to the Americas, Caribbean and Europe [7]. The TAS comprised the following three journeys: (1) Outward passage from Europe to Africa carrying manufactured goods; (2) Middle passage from Africa to the Americas/Caribbean carrying African captives and other commodities; and (3) Homeward passage carrying sugar, tobacco, rum, rice, cotton and other goods back to Europe. These slave routes included diverse countries. The European countries involved in the TAS were Portugal, France, Netherlands, Spain, Denmark, Norway and United Kingdom. Slaves were primarily imported from the African countries – Benin, Nigeria, Ghana, Gambia, Senegal, Mozambique, and Angola. The middle passage took the slaves from Africa to the American and Caribbean countries – Barbados, Cuba, Haiti, Dominican Republic, Netherlands Antilles, Trinidad and Tobago, Jamaica, Brazil, and the US. Most of the slaves ended up in South America or the Caribbean with about 500,000 transported to North America. Unfortunately, most of the slaves in the Caribbean, Central America and South America died while the slave population in North America had higher life expectancy [7].

Objective
In this manuscript, we explored the burden of prostate cancer among the TAS population targeting Black men of West African Ancestry to answer the question:Does the prostate cancer disparities seen in Black men around the world follow the path of the TAS?

Publication supported in part by the University Of Pittsburgh Graduate School Of Public Health, the University of Pittsburgh Cancer Institute, and by the National Institute of Health, grant number R13CA130596A.
http://www.biomedcentral.com/content/pdf/1750-9378-4-S1-info.pdf
Conference
Second Annual International African-Caribbean Cancer Consortium Conference
12–13 May 2008
Miami, FL, USA

PMCID: PMC2638461
Copyright © 2009 Odedina et al; licensee BioMed Central Ltd.

1H. Lee Moffitt Cancer Center, Tampa, Florida, USA
2Federal Medical Center (FMC), Abeokuta, Nigeria
3Barts and The London NHS Trust and Newham University NHS Trust, London UK
4Princess Margaret Hospital in Nassau, The Bahamas
5Florida A&M University, Tallahassee, Florida, USA
6Dana-Farber Cancer Institute, Boston, Massachusetts, USA
corresponding authorCorresponding author.
#Contributed equally.
Folakemi T Odedina: Folakemi.odedina@moffitt.org ; Titilola O Akinremi: bakinremi2@aol.com; Frank Chinegwundoh: Frank.Chinegwundoh@nhs.net; Robin Roberts: robinnassau50@yahoo.com; Daohai Yu: Daohai.Yu@moffitt.org; R Renee Reams: Renee.reams@famu.edu; Matthew L Freedman: freedman@broad.mit.edu; Brian Rivers: brian.rivers@moffitt.org; B Lee Green: lee.green@moffitt.org; Nagi Kumar: Nagi.kumar@moffitt.org

Supplement
Second Annual International African-Caribbean Cancer Consortium Conference
Camille Ragin and Emanuela Taioli

Image via Wikipedia