UK Study to Assess Causes of Greater Prostate Cancer Risk Among Black Men

UK Study to Assess Causes of Greater Prostate Cancer Risk Among Black Men

Enrollment has resumed in a five-year U.K. study investigating genetic factors behind the higher risk of prostate cancer in men of African and Caribbean descent.

The study involves researchers at The Institute of Cancer Research (ICR) and The Royal Marsden NHS Foundation Trust, in London, who will run initial biopsy and genetic profiling tests.

Black men have a higher risk of developing prostate cancer and are more likely to die from the disease than men of other ethnicities. In the U.K., it is estimated that one in four Black men will be diagnosed with prostate cancer in their lifetime, representing twice the risk for all men.

“It is vitally important that we understand what it is that makes prostate cancer more common in men of African and Caribbean descent,” Rosalind Eeles, MD, PhD, the study’s leader and a professor of oncogenetics at the ICR, said in a press release.

“We know the secret may lie in changes in the DNA passed on through generations and inherited by the men from their parents. But the only way to understand fully the role played by genetics is to do a study like this one, with enough participants to be able to see the bigger picture,” added Eeles, who is also an honorary consultant clinical oncologist at The Royal Marsden.

Matthew Hobbs, PhD, director of research at Prostate Cancer UK, which is also funding the study in partnership with Movember, said that “this study could greatly improve our understanding of black men’s risk.”

“It could not only help us find the men most at risk of getting prostate cancer, but can also point the way to better tests and treatments that could save their lives,” he added.

The trial, called PROFILE (NCT02543905), aims to recruit 350 men, age 40–69, who have never been diagnosed with prostate cancer, and whose parents and all four grandparents have African or Caribbean ancestry. Participants will be recruited at the ICR and Royal Marsden Hospital, and at several other sites in the U.K., until June 1, 2021.

The study will involve initial genetic profiling (through a blood sample and optional prostate biopsy), followed by targeted prostate screening — prostate-specific antigen (PSA) testing, MRI scans, and prostate biopsy — for five years. Of note, PSA is a protein often used as a marker of prostate cancer.

“We believe this study will not only enhance our knowledge of the higher risk in African and Caribbean men, but also open up the possibility of better tests to screen these patients and detect the disease earlier,” Eeles said, noting that “picking up the disease early, when it is easier to treat, is crucial to improving survival rates.”

“Finding new genetic clues to prostate cancer could also lead to new approaches to treatment,” she added.

Researchers hope to raise awareness of this increased risk for Black men and encourage those who are eligible to take part in PROFILE, which has resumed enrollment after a temporary pause due to the COVID-19 pandemic.

“It is now crucial that we’re able to encourage men to sign up so that we can complete this vital work as quickly as possible,” Hobbs said.

“In the meantime, we know that fewer men have been tested for prostate cancer during the pandemic,” he added. “It’s therefore essential that men most at risk — including Black men over 45 — speak to their [general practitioner] about whether a PSA test is right for them.”

Frederick Forster, a PROFILE participant whose father died of prostate cancer nearly 15 years ago, said: “I know my family history and ethnic background put me at greater risk of developing prostate cancer, so I want to help the researchers and doctors find out why this is and what can be done about it.”

“The big ‘C’ word isn’t something you take lightly and I think there’s probably reluctance among African and Caribbean men to come forward and get tested. Who knows, by taking part in this trial, maybe I could save a life further down the line,” he added.

PROFILE was also designed to identify genetic factors associated with a higher risk of prostate cancer among 350 Caucasian men, 40–69 years old, with a family history of the disease.

This family history was defined as having a first degree relative or two relatives on the same side of the family diagnosed with prostate cancer before age 70, or three same-side relatives diagnosed with prostate cancer at any age. Enrollment in this part is already complete.

The study expands on a previous small-scale (pilot) version, assessing whether 100 men from the target population would be willing to undergo more intensive prostate screening and have samples taken for genetic analysis.