A recent study analyzing DNA from over 5,000 military veterans with metastatic prostate cancer found that nine of the ten most commonly altered tumor genes were shared between Black and White men. Yet, one gene—TP53—was more frequently mutated in Black men and linked to worse survival outcomes. While the study suggested genomic testing could help guide treatment, some experts argue it misses the deeper issue.
Dr. Mack Roach III of UCSF criticized the focus on TP53, stating, “They don’t show that genetic alteration is related to race.” He emphasized that the presence of TP53 mutations was associated with poor outcomes across all racial groups, with nearly identical hazard ratios. “The study doesn’t show prostate cancer is more common in Black men, and it doesn’t explain the excess mortality rate,” Roach said.
The real disparity, according to Roach and other researchers, lies in unequal access to care. Studies show that when treatment is equitable, Black men have outcomes equal to or better than White men. “There is no inherent biologically more aggressive prostate cancer in Black men,” Roach added.
This research underscores the need to look beyond genetics and address systemic barriers in healthcare. Without equal access to early detection and quality treatment, Black men will continue to face higher mortality rates—not because of biology, but because of inequity.
See “Genetics Aren’t Just Killing Black Men With Prostate Cancer, Poor Healthcare Is” (June 10, 2025)
