Black Americans are at a higher risk of getting prostate cancer than white Americans. Survival rates are lower, too.

The gap is narrowing, but Black people are still at risk for developing prostate cancer earlier in life and being diagnosed at a more advanced stage. We’ll discuss why researchers think there’s a disparity and current recommendations for screening for prostate cancer.

The following are some of the risk factors — including race — that are associated with developing prostate cancer:

  • Ethnicity: African American men are at higher risk of developing prostate cancer than white, Hispanic, or Asian men.
  • Age: Most cases of prostate cancer are diagnosed after the age of 65.
  • Geography: Prostate cancer diagnosis is more common in North America, northwestern Europe, Australia, and the Caribbean than in other parts of the world. This may be due to more screening for cancer or lifestyle differences.
  • Family history: Having one or more relatives with prostate cancer increases your chance of getting the disease.
  • Genetic changes: Inherited gene mutations in BRCA1 and BRCA2 genes and Lynch syndrome are associated with increased risk of prostate cancer.

Based on data from 2014 to 2018, the rate of prostate cancer among Black men was 172.6 per 100,000, compared to a rate of 99.9 per 100,000 white men.

Recent data shows how much race is a risk factor for getting prostate cancer:

  • According to statistics reported in 2022, over the last 5 years, Black men have been about twice as likely to die from prostate cancer compared to white men.
  • The 5-year prostate cancer survival rate for localized cancer is 96 percent for Black men, compared to 98 percent for white men (based on data from 2011 to 2017). Metastatic prostate cancer survival rates are lower.
  • Based on data from 2016 to 2018, the lifetime probability that a Black man will die from prostate cancer is 1 in 26, compared to 1 in 44 for a white man.
  • Black men develop prostate cancer at a younger age than white men, and the cancer is 44–75 percent more likely to metastasize before diagnosis.

While Black men are still at higher risk, the discrepancy has been narrowing over the last two decades. As of 2019, the prostate cancer death rate for Black men had gone down 55 percent since it peaked in 1993. Improved survival rates may be due to better surgical and radiology treatments, the use of hormone therapy, and earlier detection.

Nearly 100 percent of men (regardless of race) who are diagnosed with prostate cancer at an early stage will survive at least 5 years. Those early stage diagnoses make up 84 percent of prostate cancer cases in Black men. The 5-year survival rate for advanced-stage prostate cancer is also similar in Black and white men, about 30 percent.

However, Black men are more likely to die from cancer of any type because they’re more often diagnosed after the cancer has progressed to an advanced stage that’s difficult to treat.

Black Americans’ risks are not just higher for prostate cancer. Black people alsoo experience the highest death rates and lowest survival rates of any ethnic group for a number of conditions, including most cancers, heart disease, stroke, and diabetes.

Researchers have proposed some socioeconomic reasons Black people experience worse health outcomes:

  • inadequate health insurance
  • less access to cancer prevention, diagnosis, and treatment
  • treatments for advanced cancers are less effective and more expensive

Black people in the United States are more than 2.5 times as likely to live in poverty than white people, which impacts their access to health insurance and medical care.

A 2020 study of prostate cancer patients with equal access to healthcare regardless or race found that African American men were not diagnosed with more advanced cancer and did not experience worse outcomes than their non-Hispanic white peers.

Genetics may also play a role in the disparity of prostate cancer mortality among men of African descent. Other research suggests that the racial differences in prostate cancer outcomes could be related to inflammation and immune response. Scientists propose that treatments focused on inflammation and immunity could be especially effective for men of African descent.

Other factors, including distrust of medical professionals, may be at play as well.

Screening for prostate cancer is not standard or generally recommended for people at low or average risk. Men with risk factors listed above should discuss screening with their doctor and make an informed individual decision. Prostate-specific antigen screening is imperfect and may lead to false detection of cancer and unnecessary invasive procedures.

If prostate cancer is suspected based on antigen screening or a digital rectal exam, further tests — like imaging or biopsy — are needed to confirm a diagnosis.

Standard treatments for prostate cancer include active surveillance, surgery, radiation therapy, hormone therapy, chemotherapy, immunotherapy, and ultrasound. Being aware of your options for screening and treatment is a good first step for talking with your doctor about increased risk for prostate cancer if you’re Black.

It’s recommended that high risk populations be screened earlier than the average age of screening, which is 55.

Talk with your doctor about prostate health if you have any of the following symptoms of prostate cancer:

  • trouble starting urination
  • weak or interrupted urine flow
  • frequent urination
  • pain during urination
  • trouble emptying your bladder
  • blood in urine or semen
  • painful ejaculation
  • pain in the back, hips, or pelvis

It’s important to note, however, that prostate cancer is often asymptomatic in its early stages. The Prostate Cancer Foundation recommends that men with a family history of prostate cancer and African American men be screened as early as age 40, regardless of the presence of symptoms.

Ethnicity can factor into the risk of prostate cancer. Black men are more likely to be diagnosed at an advanced stage of cancer and are twice as likely to die from prostate cancer as white men.

The disparity is likely due to differences in socioeconomic status and access to healthcare, along with genetic factors. Black men may benefit from additional screening for prostate cancer.