Minireview: The Molecular and Genomic Basis for Prostate Cancer Health Disparities

- Author Affiliations

Barbara Ann Karmanos Cancer Institute (I.J.P., A.B.-F.); Departments of Urology (I.J.P.) and Oncology (A.B.-F.), Wayne State University School of Medicine (I.J.P., A.B.-F.), Detroit, Michigan 48201

Address all correspondence and requests for reprints to: Isaac J. Powell, 4201 Saint Antoine Street, UHC-7C, Detroit, Michigan 48201. E-mail: ipowell@med.wayne.edu.

Abstract

Despite more aggressive screening across all demographics and gradual declines in mortality related to prostate cancer (PCa) in the United States, race disparities persist. For African American men (AAM), PCa is more often an aggressive disease showing increased metastases and greater PCa-related mortality compared with European American men. The earliest research points to how distinctions are likely the result of a combination of factors, including ancestry genetics and lifestyle variables. More recent research considers that cancer, although influenced by external forces, is ultimately a disease primarily driven by aberrations observed in the molecular genetics of the tumor. Research studying PCa predominantly from European American men shows that indolent and advanced or metastatic prostate tumors have distinguishing molecular genomic make-ups. Early yet increasing evidence suggests that clinically distinct PCa from AAM also display molecular distinctions. It is reasonable to predict that further study will reveal molecular subtypes and various frequencies for PCa subtypes among diverse patient groups, thereby providing insight as to the genomic lesions and gene signatures that are functionally implicated in carcinogenesis or aggressive PCa in AAM. That knowledge will prove useful in developing strategies to predict who will develop advanced PCa among AAM and will provide the rationale to develop effective individualized treatment strategies to overcome disparities.

Footnotes

Abbreviations:
aCGH

arrayed comparative genomic hybridization

AAM

African American men

AR

androgen receptor

EAM

European American men

EGFR

epidermal growth factor receptor

ERG

v-ets erythroblastosis virus E26 oncogene homolog

ETS

E-twenty six

OR

odds ratio

PAH

polycyclic aromatic hydrocarbon

PCa

prostate cancer

PSA

prostate-specific antigen

RP

radical prostatectomy

SEER

Surveillance, Epidemiology, and End Results

SES

socio-economic status

SNP

single nucleotide polymorphism

VDR

vitamin D receptor.