Racial Disparity in Utilizing Genetic Testing for Personalized Care of Prostate Cancer

Abstract

Significant racial disparities in prostate cancer incidence and mortality have been reported between African American Men (AAM) who are at increased risk for prostate cancer, and European American Men (EAM). In most of the studies carried out on prostate cancer, this population is underrepresented. With the advancement of genome-wide association studies (GWAS), several genetic predictor models of prostate cancer risk have been elaborated, as well as numerous studies that identify both germline and somatic mutations with clinical utility. Despite significant advances, the AAM population continues to be underrepresented in genomic studies, which can limit their generalizability and potentially widen disparities. Here we outline racial disparities in currently available genomic applications that are used to estimate the risk of individuals developing prostate cancer and to identify personalized oncology treatment strategies. While the incidence and mortality of prostate cancer are different between AAM and EAM. the biological features and differences of prostate tumors in AAM and EAM are still being described. Samples from AAM remain to be unrepresented in different studies. This disparity impacts the available genomic data on prostate cancer. As a result, the disparity can limit the predictive utility of the genomic applications that have been developed and may lead to widening disparities. More studies with substantially higher recruitment and engagement of African American patients are necessary to overcome this disparity.