Penn Medicine Tackles Prostate Cancer Disparities Free

The National Institute on Minority Health and Health Disparities (NIMHD) has awarded a $12-million grant to the University of Pennsylvania's Perelman School of Medicine in Philadelphia to form the Center of Excellence in Prostate Cancer Disparities.

“Ours is a virtual center that allows us integrate different types of researchers and data from around the world,” says principal investigator Timothy Rebbeck, PhD, director of the Center for Genetics and Complex Traits in the Perelman School and Associate Director for Population Sciences at Penn's Abramson Cancer Center.

African-American men are 60% more likely than Caucasian men to develop prostate cancer, are more likely to present with aggressive disease, and are 2.5 times as likely to die from it.

Rebbeck, who leads the Men of African Descent and Carcinoma of the Prostate (MADCaP) consortium, promotes worldwide efforts to expand genetic and epidemiologic research on the disease—collaborating with investigators and setting up research centers in Africa, Europe, and the Caribbean.

“While the human genome initiative has been very successful, it is mostly based on European and Asian populations, and very few African populations,” Rebbeck points out. “But within the African diaspora, genetic variation is incredibly diverse, and we have only scratched the surface when it comes to understanding the implications of this variation.”

In a study published in January 2012 in Cancer Epidemiology, Biomarkers & Prevention, Rebbeck and colleagues showed that variants at a number of loci including chromosome 8q24 are strong predictors of prostate cancer in African-American men and hold the potential to improve screening for men at high risk.

“There are more than 60 loci linked to prostate cancer,” notes Rebbeck. “And so there is a lot to piece together. But overall, we are finding clear differences between the genetic patterns in different racial groups that may help explain disparities.”

Rebbeck points out that many factors likely influence risk of prostate cancer. To address this, the center is gathering population data ranging from genetics and basic biology to environmental factors, access to care, neighborhood factors, and behaviors such as diet or weight gain.

As one route toward understanding the impact of environmental stress, researchers in the Center of Excellence will measure the length of telomeres, which may shorten in response to chronic stress exposure. “We want to know if men who live in unfavorable environments and experience high levels of stress for long periods are at increased risk for prostate cancer, and if telomere length is a surrogate biomarker for exposure to stress,” he says.

Ultimately, the center aims to create comprehensive risk models and generate actionable data and biomarkers to identify which men will benefit the most from aggressive screening and treatment for the disease.