Black men are at a higher risk for prostate cancer than their white counterparts, experiencing earlier diagnoses, more aggressive forms of the disease, and significantly higher mortality rates. Prostate cancer remains the second most common cancer among men, but its impact on Black men is disproportionately severe, with studies highlighting a stark difference in both incidence and outcomes.

According to Dr. Sheel Patel, a board-certified physician specializing in hematology, oncology, and internal medicine, prostate cancer is especially prevalent among Black men. “One in six Black men will develop prostate cancer in their lifetime, compared to one in eight men overall,” he explained. Prostate cancer accounts for 37% of all cancer diagnoses among Black men and leads to 17% of cancer-related deaths within this group, second only to lung cancer.

Globally, prostate cancer is the second most common cancer in men, with nearly 1.4 million new cases diagnosed in 2020 alone. African American men are reported to have the highest incidence of the disease worldwide, a troubling statistic that points to systemic health disparities. In the United States, Black men have more than double the incidence and mortality rates of prostate cancer compared to white Americans, and their rates are three to four times higher than those of Asian American men.

Several factors contribute to the increased risk faced by Black men. One key factor is the earlier onset of the disease. On average, Black men are diagnosed with prostate cancer about three years earlier than white men. This could be linked to the fact that Black men often exhibit symptoms of prostate cancer, such as an enlarged prostate, at an earlier stage. Furthermore, some studies suggest that African American men tend to experience puberty earlier than their white counterparts, a factor that may increase the risk due to prolonged exposure to testosterone, which fuels prostate cancer development.

The survival rate for Black men diagnosed with prostate cancer is troubling. Despite similar five-year survival rates across racial groups—around 99% for both Black and white men—prostate cancer remains the second leading cause of cancer death among Black men. This high mortality rate can be attributed to a range of factors, including delayed diagnosis, limited access to healthcare, and socio-economic disparities that make it harder for Black men to receive timely and adequate medical care.

Genetics also play a role in the risk of prostate cancer, although not in every case. Inherited genetic mutations are found in up to 10% of prostate cancer patients, and family history can increase the risk. Men with a parent or sibling who has had prostate cancer are more than twice as likely to develop the disease themselves, particularly if their relative was diagnosed at a young age.

The higher mortality rate among Black men with prostate cancer is influenced by a combination of genetic, lifestyle, and systemic health factors. These include challenges like lower socioeconomic status, lack of access to quality medical care, delayed screenings, and exposure to environmental risk factors. Additionally, lifestyle factors such as poor diet, smoking, and lack of exercise can exacerbate the risks.

Regarding prostate cancer screening, there is no universal consensus, but recommendations vary depending on a man’s risk factors. The American Urological Association advises that Black men begin screening at age 40, earlier than the general recommendation of age 50 for men without risk factors. Some cancer organizations recommend beginning discussions around screening at age 45 for those at higher risk, such as Black men.

While there are no specific guidelines for more frequent screenings solely based on race, the increased risk factors for Black men suggest that more proactive measures might be necessary. As prostate cancer continues to disproportionately affect Black men, early detection and increased awareness remain crucial in improving outcomes for this vulnerable group.