According to Globcan, prostate cancer is the most frequently diagnosed cancer among men in over one‐half the countries of the world including the Americas, Northern and Western Europe, Australia/New Zealand, and much of Sub‐Saharan Africa. It is the leading cause of cancer death among men in 46 countries, particularly in Sub‐Saharan Africa and the Caribbean.
Although there are no reliable statistics on the incidence of prostate cancer amongst South African men, it is possible to get an idea of how common prostate cancer is in South African men by looking at the data from countries where men have reasonable access to screening for prostate cancer and where there is a significant population of black men with African ancestry. (Race is a proven risk factor for prostate cancer with black American and Jamaican men of African descent having the highest recorded rates of prostate cancer worldwide).
In the USA approximately 11.2 percent of all men will be diagnosed with prostate cancer at some point during their lifetime according to The SEER data from the National Cancer institute. (3) However if we compare the rates of prostate cancer in white vs black African American men there is a significant difference. It is estimated that 1 in 6 black African American men will be diagnosed with prostate cancer in their lifetime compared with 1 in 8 white American men. If we look at the data from 2008 to 2012 it showed that Black African American men had a 70% greater chance of being diagnosed with prostate cancer than white American men. They were also more than twice as likely to die from prostate cancer as their white counterparts, although this has improved in recent years.
One major advantage that black American men have over black South African men is that they are more likely to be diagnosed when the cancer is at a local or regional stage. (In other words, before it has spread to other parts of the body). This means that after 5 years most of these men will still be alive. In South Africa, the majority of black men will only be diagnosed when the cancer has spread, this is called metastatic prostate cancer and it is incurable. This means that after 5 years only about 30% of these men will still be alive. (5) Black African men from Southern Africa appear to have an additional disadvantage in that they present with significantly more aggressive prostate cancer than African Americans.
According to Prostate Cancer UK, 1 in 8 men will be diagnosed with prostate cancer at some point in their lives and for black British men of African descent 1 in 4 men can expect to be affected.
We recommend that black South African men consider screening from the age of 40 and that other ethnic groups start screening from 45.
Prostate cancer is more common in men with a family history of prostate cancer. If you have a family history of prostate cancer you are twice more likely to get prostate cancer. Having a brother with prostate cancer appears to put you at a higher risk than if you have a father with prostate cancer. The more members of your family are affected by prostate cancer, the more likely you are to get it.
There is some evidence showing that prostate cancer is also more common in men who have a first degree relative who has been diagnosed with breast cancer, particularly when the breast cancer was diagnosed before the age of 50. Men who have a daughter who has been diagnosed with breast cancer have a higher risk for aggressive prostate cancer.
We recommend that men with a family history of prostate or breast cancer in a first degree relative consider screening from the age of 40.
Conclusion
● Based on current USA and UK data and various clinical studies:
● About 1 in 8 to 1 in 9 white South African men are likely to be affected by prostate cancer.
● As life expectancy amongst black South African men increases, between 1 in 4 and 1 in 6 men are likely to be affected by prostate cancer. Black men are more likely to get prostate cancer at a younger age and a more aggressive type of prostate cancer.
● Prostate cancer is more common in men with a family history of breast and prostate cancer.
● Men who are at increased risk for prostate cancer because of their race or family history should consider screening for prostate cancer from the age of 40
● All other men should consider screening from the age of 45. – prostate-ca.co.za
