Men from West Africa, Caribbean have higher incidence of prostate cancer in Ontario: new study

Nearly 10 years ago, Ken Noel was diagnosed with prostate cancer, and after undergoing several tests and procedures, he began his journey for treatment in 2013, undergoing a surgery followed by radiation treatment.

"It was a really big shock to me," said Noel, who immigrated to Canada from Guyana 50 years ago.

"I led a fairly healthy lifestyle, exercised several times a week. I was a vegetarian, so it was a big surprise to me when I found out that I was diagnosed with prostate cancer."

Noel, 61 at the time, said he could not understand why he was diagnosed with the disease.

"I could not find enough information about prostate cancer and why it affected me particularly," Noel said.

A new study published in the Canadian Medical Association Journal suggests that men like Noel who immigrated from West Africa and the Caribbean have significantly higher incidence of prostate cancer than other immigrants and long-term residents in Ontario.  

In Canada, one in nine men will be diagnosed with prostate cancer during their lifetime, and one in 29 will die from it. It is the most common cancer found in men and the third-leading cause of death from cancer in men in the country, according to the Canadian Cancer Society.

Dr. Aisha Lofters, a family physician and chair in implementation science with the Peter Gilgan Centre for Women's Cancers at Toronto's Women's College Hospital, led the study.

She said it proves more research needs to be done in an area that is often overlooked.

"There [is] no race based data in Canada," Lofters said.

"We were not able to look at race, but we realized that we would be able to look at the provincial-level at immigration data."

Environmental exposure, genetics likely causes, study says

According to the report, which looked at population-based data between 2008 to 2016, Ontario has the second-highest age-standardized incidence rate of prostate cancer of all provinces, at 121.8 cases per 100,000.

Men who had immigrated from West Africa and the Caribbean had 171 per cent and 90 per cent, respectively, higher incidences of prostate cancer, the study shows.

"Prostate cancer is common worldwide, but its patterns are different in different countries and parts of the world," said Lofters.

The study also found that men from South Asia tend to have a lower incidence than other men.

Lofters said while there is no known cause for this type of cancer, a number of factors are often considered, including environmental exposures, age and genetic causes.

"The fact that we see these big differences means that we need to do some research to understand what's causing it and what we can do to address it," she said.

Noel has been cancer-free since 2013. He is now president of the Walnut Foundation, a men's health group that raises awareness within the Black community and urges men to look into their family history for known diseases, get screened early and regularly and developing a good relationship with their doctors.

Noel said these findings help provide a clearer picture of the extent of the disease within the Black community. 

Advocates, experts urge screening early

Encouraging Black men to screen early and often is crucial in tackling the numbers in the community and saving lives, he said.

"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 there's a family history of prostate cancer," Noel said. 

The study says future research should focus on further explore prostate cancer risk and epidemiology, including screening, stage of diagnosis, treatment patterns and mortality.

"Prostate cancer is not a death sentence and can be caught early if we're vigilant," Lofters said.

"Identifying 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 more stories about the experiences of Black Canadians — from anti-Black racism to success stories within the Black community — check out Being Black in Canada, a CBC project Black Canadians can be proud of. You can read more stories here.