BY LASHAWNA GRIFFITH
Prostate Cancer is one of the leading cancers in the Caribbean as there have been 1.3 million new cancer cases and 666,000 deaths were estimated to have occurred in 2018 in Latin America and the Caribbean.
In an article published by the Pan American Health Organization, it stated that prostate cancer is a serious public health problem.
“Clearly, prostate cancer is a serious public health problem in the Caribbean, where a high incidence and mortality rates affect a predominantly black population with an ancestral, genetic predisposition to the disease. Many cultural and social norms are proving to be obstacles to prevention and control among Caribbean men.”
But why are Caribbean men falling susceptible to the effects of prostate cancer?
The argument can be made that many of the issues affecting Black Caribbean men date back to the hardships of slavery, and the diet of Black men in the Caribbean.
In an article titled Prostate Cancer in the Caribbean-African Community, it noted that African-Caribbean men have the highest risk of prostate cancer, which is the second most common male cancer worldwide.
“In the UK, prostate cancer is the most common male cancer and the second most common cause of cancer death in men after lung cancer. In their current strategy, the UK Department of Health has addressed the impact of inequalities on cancer outcomes.
African-Caribbean ethnicity is a known risk factor for prostate cancer. Ethnic disparity in prostate cancer has become an important issue worldwide because of the higher incidence and mortality in the African Caribbean population. The National Cancer Institute defines ‘cancer health disparities’ as ‘adverse differences in cancer incidence (new cases), cancer prevalence (all existing cases), cancer death (mortality), cancer survivorship, and burden of cancer or related health conditions that exist among specific population groups in the United States.
The focus on identifying areas of research in ethnic disparity in prostate cancer is increasing. We have examined the current knowledge of epidemiological features and prostate cancer in the African-Caribbean community. African-Caribbean men have the highest risk of prostate cancer, which is the second most common male cancer worldwide. The authors present an overview of the epidemiology, genetic factors and disparities in the management of prostate cancer in the African Caribbean community.”
In the article, there is clear evidence of the difference in prostate cancer between Black and White men, as carried out in the research conducted by Niyukta Thakare and Frank Chinegwundoh.
“The management pathway of prostate cancer starts at the detection stage. Screening is a controversial issue and, although selective screening of high-risk groups seems reasonable, screening studies focused on ethnic minorities are lacking.
In the large screening trials, including the: Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, which constitute the existing evidence, ethnic groups including African-Caribbean men were under-represented. There is an ongoing argument for selective screening of African-Caribbean groups, and it remains to be seen whether it will become common practice. In the UK, the Prostate Cancer in Ethnic Subgroups (PROCESS) study investigated differences in prostate cancer between African-Caribbean and White men.
The study comprised a retrospective cohort of men diagnosed with prostate cancer in the London and Bristol areas over a five-year period. It concluded that African-Caribbean men were at a substantially higher risk of developing prostate cancer compared to White men, especially in the younger age group.
Several studies, particularly in the US, have queried the differences in disease presentation, tumour stage and tumour burden among ethnic groups. A systematic review of these disparities revealed that African American men present at a younger age and also have higher-risk disease and higher humour volumes. Similarly, the management of low-risk disease in African-Caribbean men has also been scrutinized. There is increasing concern regarding the role of active surveillance in low-risk prostate cancer in African-Caribbean men.”
There is still a lot of research to be conducted on why African-Caribbean men are being diagnosed with prostate cancer in such high numbers.
However, for the month of November countries around the world are asking men to get their PSA test and their regular prostate exams as early detection can lead to unwanted deaths of men from prostate cancer.
