Prostate cancer among Asian Americans

Abstract

Prostate cancer, the most commonly diagnosed cancers in men, is a clinically heterogeneous disease. Some tumors remain indolent with little impact on morbidity and survival, while others are aggressive and rapidly progress to advanced and lethal disease. Studies of prostate cancer incidence have shown considerably higher incidence rates among Asian-American men living in the United States (US) relative to Asian men living in Asian countries. Although differences in screening practices by prostate-specific antigen (PSA) testing likely account for some of the differences in incidence, the adoption of Western lifestyles with migration to the US may play a role and involve the interplay between genetic and environmental factors. Epidemiological studies have examined migration-related risk factors among Asian Americans, capitalizing on the unique heterogeneity of specific Asian populations by generational status and acculturation. Age, race/ethnicity, family history, and genetic susceptibility are established risk factors for prostate cancer. Additional risk factors that have been implicated include hormonal and infection/inflammatory factors, body mass index, diabetes, physical activity, smoking, and dietary intake of animal and polyunsaturated fat, soy products, and green tea. In this chapter, we summarize our current understanding of the epidemiology of prostate cancer in Asian-American populations.