Prostate cancer is the second most common cancer among men worldwide, and the most common cancer among men in Canada. A recently published population-based study led by Dr. Aisha Lofters, Women’s College Hospital (WCH) family physician, scientist and Chair in Implementation Science at the Peter Gilgan Centre for Women’s Cancers, found that men who had immigrated from West Africa and the Caribbean had significantly higher incidence of prostate cancer than other immigrants and long-term residents in Ontario.
Two of the study authors – Dr. Lofters and Kenneth Noel, President of The Walnut Foundation, prostate cancer survivor and certified peer navigator – spoke about this research and why it’s important to raise awareness about the higher incidence for these men.
WCH: Tell me a bit about your research on the differences in prostate cancer risk among immigrants. What did it focus on? What were the findings? What are the implications of these findings?
Dr. Lofters: We wanted to understand if there were certain immigrant groups who were at higher risk of developing prostate cancer than others. Prostate cancer is common worldwide, but its patterns are different in different countries and parts of the world. What we found was that men who had immigrated from West Africa and from the Caribbean had a notably higher incidence of prostate cancer than other men. We also found that men from South Asia tended to have a lower incidence than other men. This question, as far as we could tell, has not been studied much in the Canadian literature before. There is still a lot to be learned about prostate cancer and what causes it, but this does highlight groups who should be aware of prostate cancer, and groups who clinicians should remember may be at higher risk of prostate cancer.
Were any of the findings particularly surprising for you or your team?
Dr. Lofters: We were not surprised at the results, as there has been literature from other countries showing that men of West African ancestry are at higher risk of prostate cancer (many Caribbean men are of West African ancestry due to the history of trans-Atlantic slave trade). We were surprised that there has not been much research in this area in Canada. We cannot just rely on US findings for our population.
What needs to be done to raise awareness about prostate cancer among higher risk groups?
Dr. Lofters: We need to raise awareness among men, but also among their families, communities in general and the healthcare community. All these players can help spread the word and empower men with information.
Kenneth Noel: There are several avenues that we’re considering beyond the church and community groups that we [The Walnut Foundation] currently communicate through. We must raise our social media communications strategies, employ popular sports figures to help get the message out, engage sports groups, collaborate with other Black organizations across Canada, etc. In addition, we must employ strategies to address the mental health aspect associated with a prostate cancer diagnosis.
Why is this research important?
Dr. Lofters: Prostate cancer is not a death sentence and can be caught early if we are vigilant. Knowing men who may be at higher risk helps us all to be alert and bear this diagnosis in mind when symptoms occur, or to be especially vigilant if a man has a family history of prostate cancer, for example. It’s also important, in general, that we are not taking a one-size-fits-all approach to research by trying to understand who is at higher risk. Future research really needs to try to figure out the why for prostate cancer as well.
Kenneth Noel: In the work that we do as a foundation, we are aware that more Black men are diagnosed with prostate cancer than other ethnic groups. However, due to silence about the disease within the community plus male aversion to the testing methods and perceived threats to their masculinity, these issues have prevented us from having a clear picture of the extent of the disease within the Black community. This research study presents specific data that supports what we are seeing during our community presentations and what we are hearing from the various cancer centres.
We can then use this data to raise awareness not only among the community but also among medical professionals who would encourage their black patients to get tested early, especially if cancer is present within the family
Thank you, Dr. Lofters and Kenneth!