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Differences in treatment patterns, not genetics, appear to cause wide disparities in prostate cancer outcomes, according to the results of a new study.

Prostate cancer, which affects 1 in 11 men aged 70 and older, has some of the largest disparities in outcomes across all cancer types, according to the researchers. Men with African ancestry overall have a greater burden of the disease and die more frequently from it, they reported.

In what they said is the largest study of its kind, the investigators examined data for 13,000 men with advanced prostate cancer. Men of African ancestry, compared to their peers of European ancestry, are less likely to get comprehensive genetic profiles of their tumors early in treatment, they found. Genetic profiles help to ensure that cancer therapy is properly targeted for the best outcomes. Without them, treatments have a greater risk of being ineffective.

In addition, the data showed that men of African ancestry are less likely to be participants in clinical trials for prostate cancer, potentially missing out on new treatments for aggressive forms of the disease.

At the same time, the researchers found no evidence for higher genetic risk between the two groups. The data “clearly show no notable differences in genetic mutations between the ancestries that we would target for treatment, which suggests these mutations probably are not driving disparities in advanced prostate cancer,” Brandon Mahal, MD, of the University of Miami said.

Although research should still examine the genomics of the disease, the new findings should help clinicians chart a way forward with diagnosis and equitable treatment, he added. 

“We’ve known for a couple of decades that prostate cancer disparities are some of the largest disparities we see across all cancer types. This research can help focus our efforts on what’s needed to address these disparities,” he said.

Full findings were published in The Lancet, Digital Health.

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