Prostate Cancer Among Black Men in Canada.

Background: Prostate cancer is a prevalent disease among men worldwide, exhibiting substantial heterogeneity in presentation and outcomes influenced by various factors, including race and ethnicity. Disparities in incidence, stage at diagnosis, and survival rates have been observed between Black men and those of other races and ethnicities. Objective: To compare prostate cancer outcomes between Black men and men of other races (Asian, Hispanic, Indigenous, Middle Eastern, White, Multiracial, and Other) in a universal healthcare system, with race and ethnicity self-reported. Design, Setting, and Participants: This was a prospective, observational cohort study of men diagnosed with prostate cancer between June 1, 2014, and August 28, 2023, who self-identified their race and ethnicity. Participants included men who had been prospectively enrolled in the Alberta Prostate Cancer Research Initiative from the two major urology referral centers in Alberta (University of Alberta and University of Calgary). All men with prostate cancer enrolled in the initiative were included. Exposure: Race and ethnicity. Main Outcomes and Measures: The primary outcome was the stage and grade of prostate cancer at diagnosis. Further outcomes included age and prostate-specific antigen (PSA) level at diagnosis, initial treatment modality, time from diagnosis to initial treatment, and prostate cancer–specific, metastasis-free, and overall survival. Results: A total of 6,534 men were included; 177 (2.7%) were Black, and 6,357 (97.3%) identified with another race or ethnicity. Men who identified as Black were diagnosed with prostate cancer at a younger age (mean [SD], 62.0 [8.2] years compared with 64.6 [7.7] years; P < .001) and had a lower Charlson Comorbidity Index rating (14% compared with 7% ≥1; P < .001) than men of other races. Men who identified as Black had similar prostate-specific antigen levels at diagnosis, TNM category (74% vs. 74% with T1–T2; P = .83), and Gleason Grade Group (34% compared with 35% Gleason Grade Group 1; P = .63). Black men also had similar rates of prostate cancer–specific (hazard ratio [HR], 1.10; 95% CI, 0.41–2.97; P = .85), metastasis-free (HR, 0.88; 95% CI, 0.42–1.46; P = .44), and overall survival (HR, 0.55; 95% CI, 0.25–1.24; P = .15). Conclusions and Relevance: The findings of this cohort study suggest that Black men, despite being diagnosed at a younger age, experience comparable prostate cancer outcomes compared with men of other races.