Differences in care, rather than genetics, likely explain the disparities in advanced prostate cancer between men of African and European Ancestry, according to a study in the Lancet Digital Health.
Previous studies have found that men of African ancestry die from prostate cancer more frequently than others and even bear a disproportionately greater disease burden. Researchers at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine sought to find out why.
Dr. Brandon Mahal and colleagues studied the genomic landscape of patients with advanced prostate cancer from different ancestries. To do this, they analyzed 11741 patients with advanced prostate cancer biopsies to know how often these patients had comprehensive genomic profiling (CGP). They wanted to know if CGP affected how prostate cancer progresses or is treated in different ethnic groups.
“I believe this is the largest and most representative genomic study of advanced prostate cancer in men of African and European ancestry,” said Dr. Mahal.
The researchers found that despite men of African ancestry being at a higher risk for developing aggressive prostate disease, they were less likely to get comprehensive genetic profiling of their tumors early in treatment than their European counterparts. This means patients of African ancestry do not benefit as often from genetically targeted therapy that can lead to improved patient outcomes. Instead, these patients receive other, sometimes less effective treatments due to less sophisticated testing as their cancer progresses.
Furthermore, the researchers noted that men of African ancestry were also less likely than their European counterparts to go into clinical trials for prostate cancer, potentially missing out on newer, more effective treatments for aggressive disease.
“We’ve known for a couple of decades that prostate cancer disparities are some of the largest disparities we see across all cancer types. This research can help focus our efforts on what’s needed to address these disparities,” Dr. Mahal said.
The researchers noted the important role of genomics in cancer development and called for a study into the role of genomics in men’s risk for developing prostate cancer.
Journal Source: Lancet Digital Health