African American men and hereditary/familial prostate cancer: Intermediate-risk populations for chemoprevention trials

The risk of prostate cancer diagnosis among African Americans is 66% greater than among European American men. For African Americans with a family history of hereditary prostate cancer the increased risk of diagnosis is even greater. Thus, this population should be a prime target for chemoprevention strategies. In addition to the higher incidence of prostate cancer among African Americans compared with other populations, the mortality of prostate cancer among this high-risk population is significantly greater than 100% compared with other populations, thus further demonstrating the need for chemoprevention in this target population. Autopsy studies and clinical findings support the argument that prostate cancer exhibits more aggressive biological behavior and perhaps more rapid growth among African Americans compared with European Americans. It is hypothesized that genetic and epigenetic factors may be responsible for a more rapid growth rate among African Americans compared with other populations. Accumulating evidence indicates that a diet high in fat content is closely associated with prostate cancer progression. Investigators have reported that fat intake and percentage of energy from fat were highest in African Americans, followed by European Americans, Japanese Americans, and Chinese Americans, In conclusion, African Americans are an important target population to include in chemoprevention trials that include dietary factors as preventive agents.