Prostate cancer risk is affected by neighborhood for Black men of West African ancestry

RELEVANCE

Most relevant for: Men with West African ancestry.

It may also be relevant for:

healthy people with average cancer risk

Relevance: Medium-High

Strength of Science: Medium-High

Relevance rating details

What is this study about?

This study looked at why Black men are more likely to develop and die of cancer than men of other races. Researchers looked at genetics and neighborhood factors to see how they affect prostate cancer risk. They found that men of West African ancestry were at greater risk of prostate cancer. They also found that neighborhoods can significantly impact Black men’s chance of getting prostate cancer.

Why is this study important?

Prostate cancer is the most common cancer among men in the United States. Black men with West African genetic ancestry are more likely to develop prostate cancer and are twice as likely to die of the disease. Most Black people in the United States are of West African genetic ancestry, which has been shown by international studies to increase the risk of prostate cancer.

Research also links where people live with their risk of developing or dying of prostate cancer. People who live in economically struggling neighborhoods have a higher risk of the disease. These individuals are more likely to lack regular work, stable housing and enough to eat—all factors that increase individual and community stress. These neighborhoods are sometimes described as deprived or suffering from deprivation.

This study is the first to look at how West African genetic ancestry and neighborhood deprivation combine to affect prostate cancer risk.

Study findings

This study involved 1,469 participants from Baltimore, with 733 identifying as Black and 736 as white. The average age of participants was just under 65. Study participants were enrolled in the NCI-Maryland Prostate Cancer Case-Control study, research that compares people with prostate cancer to a control group of people of the same ages and race. The research team followed participants for 15 years and used testing to determine West African ancestry.

First, the researchers wanted to determine if there was a link between West African ancestry and prostate cancer. They found that having West African genetic ancestry increased the risk of developing prostate cancer.

Next, the researchers looked at both genetics and neighborhoods.

Neighborhood was measured using a neighborhood deprivation index (NDI) score that included factors such as:

Percentage of households in poverty
Percentage of households headed by women with children
Percentage of households on public assistance
Percentage of households earning less than $30,000 a year
Percentage of unemployed people
Percentage of people in managerial jobs

A higher NDI percentage means that a neighborhood faces more challenges that can lead to stress for the community. Living in an area with high NDI was a risk factor for prostate cancer regardless of ancestry. In other words, neighborhood deprivation can affect prostate cancer risk regardless of ancestry.

Among study participants living in neighborhoods with a high NDI, having West African ancestry was associated with an greater increased risk of developing prostate cancer.

Specifically, men with West African genetic ancestry are nearly twice as likely to develop prostate cancer if they live in a neighborhood with a high NDI as other men from that neighborhood.
Among study participants living in neighborhoods with medium to low levels of NDI, having West African ancestry was associated with a reduced risk of developing prostate cancer. Specifically, men with West African genetic ancestry who live in neighborhoods with medium to low NDI have an almost 80% lower risk of developing the disease.

There was no link between neighborhoods and death from prostate cancer.

The lead authors suggest that people who live in wealthier neighborhoods may have some protection against prostate cancer risk but not against prostate cancer deaths.

What does this mean for me?

If you are a male of West African genetic ancestry you may have an increased risk of prostate cancer. If you are a male of West African genetic ancestry and living in a disadvantaged neighborhood you may additionally increase your risk of developing prostate cancer. The authors believe this may relate to higher stress caused by difficult life circumstances.

Overall, this study suggests that improving a neighborhood environment can help reduce the burden of prostate cancer for everyone regardless of ancestry. Improving neighborhood environment may lower the risk more for those with West African genetic ancestry, particularly for men living in areas with high deprivation.

Many people do not have the means or resources to improve their neighborhood environment. It’s important for people who cannot relocate to explore other ways to manage and reduce stress. Simple lifestyle changes, like getting enough rest, eating a balanced diet and staying active, can make a difference. Additionally, engaging in relaxing activities, such as spending time outdoors or with loved ones, can help. Apps and online videos that provide mindfulness meditation or yoga can also help to reduce stress. Use community resources, such as local health clinics, libraries, health fairs and community centers, if possible.

FORCE holds virtual support groups based on the communities where people identify. You can find more about our support groups here.

Reference

Pichardo CM, Ezeani A, Acevedo AM, et al. West African Genetic Ancestry, Neighborhood Deprivation, and Prostate Cancer. JAMA Network Open. 2024;7(9):e2433546.

National Cancer Institute News Release. study links neighborhood environment to prostate cancer risk in men with West African genetic ancestry. Published September 16, 2024.

Disclosure: FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

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posted 2.26.25

Questions To Ask Your Doctor

What is my risk of developing prostate cancer?
What, if anything, can I do to decrease the likelihood that I will develop prostate cancer?
Do you recommend prostate cancer screening for me at this time? What are the risks and benefits associated with this screening?
Do you recommend genetic testing for me?

Guidelines

The following are commonly used guidelines for prostate cancer screening in average-risk people. View our risk-management section for prostate cancer screening guidelines for people with mutations in genes linked to prostate cancer.

Age	U.S. Preventive Services Task Force ()	National Comprehensive Cancer Network (NCCN)	American Cancer Society (ACS)
40-45	No recommendation	Recommends discussing screening for those at high risk because they are either African American, have tested positive for a (“cancer gene”) or have a “concerning family history”. Consider establishing baseline and digital rectal examination (DRE). For those at high risk, if PSA is low (less than1 ng/mL), retest every 2 to 4 years. If PSA is 1-3 ng/mL and DRE is normal, retest annually.	Recommends discussing screening for those who have more than one who developed prostate cancer at an early age
45-49	No recommendation	Recommends discussion of PSA screening. Consider establishing baseline PSA and digital rectal examination (DRE). If PSA is low (less than1 ng/mL), retest every 2 to 4 years. If PSA is 1-3 ng/mL and DRE is normal, retest annually.	Recommends discussing screening for those at high risk because they are either African American or have a first-degree relative who developed prostate cancer younger than 65
50-54	No recommendation	Recommends discussion of PSA screening. If PSA is low (less than1 ng/mL), retest every 2 to 4 years. If PSA is 1-3 ng/mL and DRE is normal, retest annually.	Recommends discussing screening for those who have average risk and are expected to live at least 10 years
55-69	Recommends individual decision making after discussion with clinician about the possible benefits and harms	Recommends discussion of PSA screening If PSA is low (less than1 ng/mL), retest every 2 to 4 years. If PSA is 1-3 ng/mL and DRE is normal, retest annually.	Recommends discussing screening for those who have average risk and are expected to live at least 10 years
70-74	Screening not recommended	Recommends discussion of PSA screening. If PSA is low (less than1 ng/mL), retest every 2 to 4 years. If PSA is 1-3 ng/mL and DRE is normal, retest annually.	Recommends discussing screening for those who have average risk and are expected to live at least 10 years
75 and older	Screening not recommended	Screening not recommended for most people. For very healthy people (no other chronic disease), if PSA is less than 4 ng/mL and DRE is normal, may consider retesting every 1 to 3 years or discontinuing screening.	No recommendation

Of note, there are many other guidelines, some of which are considerably different than these.

Updated: 02/26/2025

Study: Neighborhood affects prostate cancer risk in men of West African ancestry