Harvard Perspectives on Prostate Disease

Unequal odds

A message from Editor in Chief Marc B. Garnick, M.D.

The Declaration of Independence proclaims that "all men are created equal." But when it comes to prostate cancer, novelist George Orwell's sentiment that "some are more equal than others" might be more apt. While one of every six men will be diagnosed with prostate cancer, individuals' odds of hearing that diagnosis vary greatly. Statistics show that African American men have the highest incidence of prostate cancer in the world. They are also more than twice as likely to die of the disease compared with white men and about five times more likely than Asians.

In study after study, no one factor accounts for the disparity — not diet, weight, socioeconomics, or biology. Prostate-specific antigen (PSA) screening has certainly helped close the gap in survival rates, yet differences persist. In this issue of Perspectives, we explore some of the possible reasons why. Among them: variations in the sequence of nucleotides in a gene called CYP3A4 that might affect how the body metabolizes testosterone.

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