“The best evidence is that racism does not cause prostate cells to become cancers, but once that malignant transformation takes place, the effects of racism influence the chances the patient will die as a result,” commentary authors write. Genetics, behavior, direct effects of racism, and indirect effects of racism are the possible explanations explored in the article, which addresses the question, “How much of the difference in mortality and incidence we should attribute to explanation (1) genetics versus explanations (3) and (4), the combined effects of racism.”
The group concludes: “Despite our title, we are not trying to be absolutist. It is entirely plausible that germline genetic differences in the Black population explain a small part of differences in prostate cancer survival and, comparably, that direct and indirect effects of racism do have a minor impact on carcinogenesis. But to best address racial differences in prostate outcomes, we have to know where to focus and what to prioritize. Understanding the distinction between carcinogenesis and survival will best help both research into prostate cancer disparities and practical efforts to alleviate those disparities.”