Secretary of Defense Lloyd J. Austin III, the first Black Pentagon chief, talked candidly about his prostate cancer diagnosis at a Feb. 1 press conference.
“I was diagnosed with a highly treatable form of cancer, and a pretty common one,” he said. “One in eight American men will get prostate cancer, and one in six Black men will get it.”
Austin, who apologized for belatedly disclosing his health challenges, raised public awareness on the racial health disparities surrounding prostate cancer.
Below we explore why Black men have the highest risk of getting prostate cancer and ways to reduce this risk.
What is prostate cancer?
Prostate cancer is one of the most common cancers in American men, according to the Centers for Disease Control and Prevention. It starts in a part of the male reproductive system known as the prostate and occurs when prostate gland cells grow out of control.
Prostate cancer affects all races, but Black men are more likely to get the disease and die from it, research shows.
Why are Black men most likely to get prostate cancer?
Here are five reasons why Black men have the highest risk of getting prostate cancer and dying from it:
1. Genetics and biology
Genetics and biology can partly explain racial disparities in prostate cancer. New research funded by the Prostate Cancer Foundation in 2023 found several unique genetic variants in men of African descent increasing their risk for prostate cancer.
One of the variants influences how aggressive the prostate cancer grows, according to a study published in European Urology, a peer-reviewed medical journal.
2. Racism in medicine
Racism may also contribute to racial disparities in prostate cancer. Then-CDC Director Rochelle Walensky in 2021 declared racism a “serious public health threat” and later suggested “CDC has long recognized that racism is the root cause of many health disparities.”
The American Medical Association defines institutional racism as “Discriminatory treatment, unfair policies and practices, and inequitable opportunities and impacts within organizations and institutions, based on race.”
Institutional racism has influenced the U.S. health care system. For example, Black men in the U.S. are “under‐enrolled and underrepresented” in phase 3 prostate cancer clinical trials, according to scientific literature published in 2022 by the American Cancer Society’s international journal.
“Clinical trials are vital in the development of novel therapies, and underrepresentation of the Black population may hinder the development of efficacious and safe oncology treatments for real‐world clinical practice,” the study said.
3. Cultural factors
Cultural factors may influence racial disparities in prostate cancer. The average Black family has less confidence in the U.S. health care system for a variety of reasons, including historical injustices against Black Americans.
The untreated syphilis study at Tuskegee is an example of U.S. malpractice against Black people. The 40-year trial between 1932 and 1972 caused unnecessary Black suffering. One of the legacies of this unethical experiment is that Black families are more likely than white families to mistrust their doctors.
Black communities may also have a greater stigma against prostate cancer than white communities, according to qualitative research. Stigmatization is a cultural factor that could influence whether someone seeks prostate cancer screening services.12
4. Limited access to health care
Black people are more likely to have limited access to health care compared with non-Hispanic whites.
According to the U.S. Census Bureau, the following percentage of working-age adults aged 19 to 64 lacked health insurance coverage in 2022:13
- 6.8% of non-Hispanic whites
- 7.4% of Asians
- 11.4% of Blacks
- 23.4% of Hispanics (any race)
Black men have the highest risk of getting prostate cancer and are much more likely to die from it than white men, data shows. Being uninsured can increase the risk, because uninsured populations generally have lower rates of getting screened for prostate cancer, according to literature published in the journal BMC Public Health in 2021.
5. Socioeconomic status
Socioeconomic status can affect a person’s ability to access diagnostic tests and treatment for malignant tumors. U.S. household income data shows Black families had the lowest median income of all racial groups in 2022:
| Race/ethnicity | Median household income |
| Black | $52,860 |
| Hispanic | $62,800 |
| Non-Hispanic white | $81,060 |
| Asian | $108,700 |
People of higher socioeconomic status typically have greater access to health care resources than patients of lower socioeconomic status, research shows.
A study published in the American Cancer Society’s international journal found more Black cancer survivors had reported financial hardship from medical debt compared with white cancer survivors. “Patients who reported financial hardship were 4.4 times more likely to limit care,” the study found.
Ways to reduce prostate cancer risk
There’s no surefire way to prevent prostate cancer, but speaking to a doctor and seeking routine medical checkups could reduce certain risk factors.
After undergoing a minimally invasive procedure to treat his prostate cancer, the U.S. secretary of defense offered some words of advice.
“I’m here with a clear message to other men, especially older men: Get screened,” Austin said. “Get your regular checkups. Prostate cancer has a glass jaw. If your doctor can spot it, they can treat it and beat it.”
Edited by: James Sutton
