There are striking differences in the rates of both incidence and mortality from prostate cancer in differing racial groups worldwide. This is true both in terms of ethnic origin and geographical location, with low risk groups such as Japanese men increasing their risk by living in the United States.

Globally, black men appear to have the highest risk and although comparison between Western countries and Africa is difficult for many reasons, it seems likely that black men living a “Western” lifestyle have the highest risk of any racial or ethnic group.

Recently a study has shown a striking increased incidence in black men in Jamaica, with strong evidence of familial risk.

Studies in the USA have shown a link between race and prostate cancer incidence as well as prostate cancer mortality, but so far no studies have addressed this issue in a European context.

It is our impression that the stage of presentation and the progression of prostate cancer in black patients in London are worse when compared to either white or Asian patients

Confirmation of this from UK Cancer registries is currently impossible: only since April 1998 has ethnic origin been part of the minimum data set received by the registries. Out of over 5000 cases of prostate cancer registered in the London area in one year less than one hundred men had accurate ethnic details. However an analysis of prostate cancer incidence and mortality in local regions shows a relationship to racial mix within those regions.

Initial results from KCH show about a 50% increased risk for black men.

If the observations above hold true for black men in the UK it may well be the case that they are at serious risk from both an intrinsically more aggressive disease and also from delayed diagnosis of their condition. Our initial limited research suggests a 50% higher number of black men with prostate cancer in the KCH catchment area. Further work needs to be done to confirm this, and a Government funded study is now under way across five centres in the UK which should give an accurate picture of the situation as well as providing a base on which to look for reasons for such differences.