To develop better treatment options and outcomes, prostate cancer clinical trials need more diversity.
Research from 2021 shows that 96 percent of participants in clinical trials for prostate cancer are non-Hispanic white men. However, the incidence rate of prostate cancer among Black men, for example, is 2.2 times higher than that in white men, with a 1.7 times higher death rate.
Black men also present with more advanced disease and higher prostate-specific antigen (PSA) levels, which indicate the presence of prostate cancer. This means Black men, among other historically marginalized groups, are inadequately represented in prostate cancer clinical trials, despite having increased risks.
While there is no clear reason for these higher numbers, several factors can affect cancer risk, including culture, religion, and socioeconomic status.
Racial disparities in prostate cancer clinical trials can contribute to disparate outcomes for men diagnosed with the disease.
Here’s everything you need to know about prostate cancer statistics, where clinical trials stand today, and how increasing diversity can save more lives.
In 2022, the
About 1 in 8 men will receive a diagnosis of prostate cancer at some point in their lives, and the disease is more likely to develop in older men and non-Hispanic Black men, according to the organization. This is because the chance of having prostate cancer rises rapidly after age 50. Non-Hispanic Black men may be at higher risk for the reasons mentioned above.
In the United States, prostate cancer is the second leading cause of cancer death behind lung cancer. It’s estimated that 1 in 41 men will die of prostate cancer.
That’s why diverse prostate cancer clinical trials are so important and can help improve outcomes in years to come.
A clinical trial is a research study that uses experiments or observations in human participants to evaluate effects on health outcomes. This can include studies on new therapies, vaccines, surgeries, or diagnostic tests.
Clinical trials help determine whether treatments or medications work, how they compare with other treatments, and whether they have any side effects. This helps researchers and medical experts determine how effective and safe given treatments are, and identify how to improve quality of life.
Diverse clinical trials matter. They help medical professionals and researchers better define the impact of therapy, quality of life, and how biomarkers impact different patient populations.
Since the majority of participants in clinical trials for prostate cancer are non-Hispanic white men, there is little opportunity to study direct effects on People of Color.
In addition to the risk Black men face, Puerto Rican men also see a 60 percent increased incidence of prostate cancer and 44 percent higher rate of death when compared with non-Hispanic white men, reports a 2012 study.
Black men represent 13.4 percent of the U.S. population, but they only make up 6.7 percent of people enrolled in prostate cancer clinical trials, according to 2021 research.
There’s an even greater disparity for Hispanic or Latino men, who make up less than 2 percent of prostate cancer clinical trial participants.
Results obtained from diverse clinical trials help medical professionals and researchers understand how race and ethnicity affect prostate cancer risks and outcomes.
These results enable factors like cultural tradition, common history, religion, and socioeconomic factors and their influence on the development of prostate cancer to be studied.
In addition, diverse clinical trials can help researchers identify issues related to preventive screenings access — or lack thereof — as well as a person’s ability to seek treatment.
Studying these factors can also help determine how things like diet, physical activity, and genetics affect the risk of developing prostate cancer. Cultural factors can play a key role in health behaviors, attitude toward illness, and belief in modern medicine, among other elements.
Diversifying prostate cancer clinical trials is essential for getting the right treatment to all populations. Nondiverse clinical trials can result in a nonrepresented population experiencing negative outcomes, such as getting the wrong dose of a drug or receiving a treatment that won’t work as well for their particular needs.
The goal is for Men of Color to enroll in prostate cancer clinical trials, among healthcare clinical trials in general. This is often easier said than done.
Men can discover or enroll in a clinical trial by visiting ClinicalTrials.gov. This searchable registry and results database includes federally and privately supported clinical trials conducted in the United States and worldwide.
A lack of resources, like limitations of translator services for men who speak a language other than English, can contribute to decreased recruitment of participants from marginalized groups. Systemic and institutional barriers can also reduce access to enrollment, as can lack of healthcare insurance.
While some of these factors ultimately depend on larger systemic changes, there are some steps people can take to help diversify prostate cancer clinical trials. These include:
- prioritizing engagement and outreach
- enrolling in clinical trials
- joining a registry, such as the IRONMAN Registry
Collecting and researching this information can help medical experts better understand what causes prostate cancer, how to stop or slow its progression, and how to provide care that allows men of all racial groups to experience the best quality of life.
As we continue to address prostate cancer risks and death rates, diverse clinical trials can go a long way in facilitating better outcomes for all men, regardless of racial or ethnic background.