Black men are 70% more likely to develop prostate cancer in their lifetime and twice as likely to die from the disease. Vincent Laudone, MSK’s Chief of Surgery at the Josie Robertson Surgery Center, explains that there are many factors that can increase the risk and worsen the outcome of prostate cancer — not just being of African descent. These include age, family history, smoking, limited physical activity, and obesity.

“The higher risk may be related to social and environmental issues involving nutrition, access to health care, and exposure to environmental pollutants,” he says. “Disparities in outcomes also can be affected by differences in when the cancer is diagnosed and how the men are treated after diagnosis.”

Additionally, prostate cancer in Black men may have biological characteristics associated with more aggressive disease. “There is evidence suggesting that this is partly related to inherited genetic factors,” says medical oncologist Andrew Laccetti. “There may be differences in tumor biology that cause this cancer in Black men to progress faster or be harder to treat, but we need to investigate this possibility further to learn more.”

Black men should be screened for prostate cancer more proactively

Given the higher risk of developing prostate cancer and dying from the disease, Black men are more likely to be saved by screening. The main prostate cancer screening tests are a digital rectal exam, in which a doctor checks for swelling and inflammation, and a PSA test, which measures the level of prostate specific antigen (PSA) in the blood.

“Screening guidelines have been based on studies that included very few Black men, so they may underestimate the screening benefit for this group,” Dr. Laccetti says. “Overall, Black men may need earlier and more frequent screening than the general guidelines would suggest.”