Prostate cancer in the African American: is this a different disease?

Age-adjusted mortality rates from prostate cancer between 1991 and 1995 are approximately two times worse among African-American men than Caucasian men. Age-specific mortality rates from prostate cancer are reported to be three times greater among African-American men compared with Caucasian men between the ages of 40 and 60 years. These statistics lead one to ask whether the difference in outcome is secondary to a more rapidly growing prostate cancer among African-American men compared with Caucasian men, or is it a result of delayed diagnosis among African-American men, which would account for there being more advanced prostate cancer at presentation? This report demonstrates many histological and biological differences that may account for clinical outcome differences.