Ethnic and racial differences in prostate cancer incidence and mortality.

Prostate cancer (CaP) incidence and mortality vary strikingly among ethnic, racial, and national groups. There is evidence that genetic, environmental, and social factors jointly-and often in combination-contribute to the observed differences in various populations. Noteworthy is the high rate of both CaP incidence and mortality among African Americans. Changes in the epidemiology of CaP since the advent of prostate specific antigen testing suggest that improved access to screening and treatment may serve to reduce somewhat the differences between the white and African-American populations. However, because the causes of these differences are likely to be multifactorial, a variety of strategies addressing the range of causes will be necessary to reduce the excess African-American mortality from this disease.