Abstract B151: Unveiling the unseen: A multi-level analysis of prostate cancer disparities in Black men under 50 and 65+ across US States and Alabama's Black belt

Abstract Despite advancements, considerable gaps exist in prostate cancer diagnosis, survival, and treatment success across the U.S., with African American populations particularly impacted.This hierarchical study investigates prostate cancer incidence and mortality among African American and Caucasian populations across all 50 U.S. states, with a specific focus on the 10 states with the largest African American populations. Additionally, the analysis includes all counties in Alabama, with particular attention to its 24 designated Black Belt counties—areas marked by a high concentration of Black residents. Data on prostate cancer incidence (2017–2021) and mortality (2018–2022) were obtained from the National Cancer Institute (NIH) and the Centers for Disease Control and Prevention (CDC). Analyses were conducted using GraphPad Prism 5, with particular emphasis on men under age 50 and those aged 65 and older. Our study consistently found significantly higher prostate cancer incidence and mortality rates (P< 0.05) among African American men compared to White men across all levels of analysis. Nationally, among men aged 65 and older, African American men experienced a 42.11% higher incidence rate and a 95.65% higher mortality rate. Among those under age 50, African American men showed a 188.12% higher incidence, and 150% higher mortality rate compared to their White counterparts, although mortality data for White and African American males in this age group were limited. In Alabama counties, these disparities were even more severe: for men aged 65 and older, incidence was 78.93% higher and mortality 189.63% higher; among those under 50, incidence was 161.9% higher and mortality 100% higher. Furthermore, prostate cancer death rates for African American men were rarely reported in Alabama counties overall. These findings underscore the urgent need for targeted public health interventions and research to address these disparities and improve prostate cancer outcomes for Black men in the U.S. Further studies should also investigate potential genomic factors contributing to these disparities. Citation Format: Faith Onomeh, Rosianna Gray, Gordon Govens, Anathbandhu Chaudhuri. Unveiling the unseen: A multi-level analysis of prostate cancer disparities in Black men under 50 and 65+ across US States and Alabama's Black belt [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B151.