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% greate r than among European American men. For African Americans with a family his tory 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 A frican 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 ch emoprevention in this target population. Autopsy studies and clinical findi ngs support the argument that prostate cancer exhibits more aggressive biol ogical behavior and perhaps more rapid growth among African Americans compa red with European Americans. It is hypothesized that genetic and epigenetic factors may be responsible for a more rapid growth rate among African Amer icans compared with other populations. Accumulating evidence indicates that a diet high in fat content is closely associated with prostate cancer prog ression. Investigators have reported that fat intake and percentage of ener gy from fat were highest in African Americans, followed by European America ns, Japanese Americans, and Chinese Americans, In conclusion, African Ameri cans are an important target population to include in chemoprevention trial s that include dietary factors as preventive agents.