Is there fat in the gap? A meta- analysis of the contribution of adiposity to racial disparities in prostate cancer

Background and Objective: Black men develop and die from prostate cancer (PCa) more than any other racial group. PCa incidence and mortality rates in Black men are 2.4 times that of their White (WH) counterparts. It is not clear how body composition, particularly central adiposity, contribute to racial and ethnic disparities in PCa occurrence and course. Current reviews on the adiposity relationship have tended not to adequately address this. Therefore, we conducted a systematic review and meta-analysis of the literature examining the role of adiposity in racial disparities in prostate cancer. Methods: The US National Library of Medicine National Institutes of Health PubMed database was searched for English articles published through October 1, 2012. No reviews, editorials, or comments were included in the review, although they were cited for background content. Results: Many of the available reviews on adiposity and PCa racial disparities did address occurrence and outcomes often did not present race-specific effect estimates and simply adjusted for race in multivariate models. The available evidence suggests a unique role of adiposity-related factors in the risk of PCa occurrence, progression, differences in treatment efficacy, and PCa-specific death. Lack of studies including sufficiently large numbers of AA prohibited reporting of race-specific estimates in many studies, especially in studies involving molecular biology and genetics. Conclusions: The results of this systematic review and meta-analysis highlight the need for more studies with robustly diverse samples. Our research must reflect the fact that Black men are most frequently and gravely affected by PCa.