Is Prostate Cancer Linked to Neighborhood Stress?

Men newly diagnosed with prostate cancer who lived in disadvantaged neighborhoods had a higher expression of stress-related genes linked with lethal prostate cancer.

The Challenge

Black men have a 73% higher incidence rate of prostate cancer than White men and are twice as likely to die from it according to the American Cancer Society (ACS) Cancer Facts & Figures for African Americans 2022-2024. This difference in mortality rate may be at least partially attributable to the African American population’s reduced access to high-quality treatment. Evidence also suggests that Black men are more likely to develop faster-growing, aggressive prostate cancer, which is more likely to be fatal. 

The underlying causes of these disparities continue to be an important focus in cancer research, with growing efforts focused on understanding the intersection between cancer, race, and social determinants of health such as stable housing and access to healthy food. According to the National Equity Atlas, Black men in the United States are more likely than White men to live in areas that have been historically disadvantaged, leading cancer researchers to look more closely at the association between social determinants of health and prostate cancer incidence, progression, and mortality. 

The Research

In a study published in JAMA Network Open, researchers examined the connection between living in a disadvantaged neighborhood and the over-expression of a specific set of genes that had previously been linked with the development or progression of prostate cancer. The study was funded by an American Cancer Society (ACS) Institutional Research Grant at the University of Maryland Greenebaum Comprehensive Cancer Center.

The researchers suspect that these genes, which are also associated with inflammation, may be overexpressed as a result of chronic stress at least partially caused by living in a disadvantaged neighborhood. When genes are over-expressed, it means that the cells are making extra copies of them, increasing the likelihood that the cell will grow abnormally and potentially become cancerous.

Researchers measured the expression levels of several of these inflammatory and stress-related genes in prostate tumors from 168 African American and 50 White men living in the Baltimore, Maryland area. They then looked at the association between these gene expression levels and 4 established indicators of neighborhood disadvantage based on where the men lived at the time of their prostate cancer diagnosis.  

From this analysis, they identified 19 different genes where overexpression was associated with at least 1 of the 4 measures of neighborhood disadvantage, and 4 genes that were associated with 2 or more measures.

Why It Matters

These findings add to the growing body of literature linking prostate cancer, race, and social determinants of health, especially those related to neighborhood quality. Because the identified genes are all associated with inflammation and/or stress responses, these findings also suggest important avenues for future work to better understand how a man’s  lived experience may affect their risk for developing cancer. 

This is particularly critical for understanding the persistent disparities in prostate cancer diagnoses and outcomes for African American men, which is one of the current research priorities for the American Cancer Society. By better understanding these important connections, we can better design and implement both biological and lifestyle interventions to reduce prostate cancer in these communities and beyond.