The Journey

Black patients more likely to be excluded from prostate cancer trials – despite having a MUCH higher risk of the disease

Black men have a higher risk of developing prostate cancer, but they are often excluded from clinical trials for the disease, new research claims.

Researchers found many African American men are shut out of these experiments because they have slightly low levels of neutrophils, a common type of white blood cell important to fighting off infections. Exclusion from these clinical trials – which give participants access to the latest medical treatments – could prevent black men from receiving proper treatment. The findings, published in JAMA Oncology, suggest researchers designing clinical trials set entry criteria that makes it harder for black patients to participate.


Black men are underrepresented in prostate cancer clinical trials, new research claims.

Black men are underrepresented in prostate cancer clinical trials, new research claims ‘Something as simple as a lab-value exclusion criteria may serve as yet another barrier to allowing African American patients to take part in randomized trials,’ said corresponding author Dr Paul Nguyen, of Brigham and Women’s Hospital.


Prostate cancer is the second leading cause of death among men in the US, but doctors still aren’t sure what causes the disease. However, risk factors for the disease include age — the older a man is the greater his risk for developing the disease, family history, and face.

For the study, Dr Nguyen and his colleagues examined a list of 401 clinical trials regarding prostate cancer. They found out more than half of the clinical trials conducted used these laboratory values, which varied by race. Many of the clinical trials measured serum creatinine (sCr), which is used to measure kidney function, and absolute neutrophil count (ANC), which is used to determine the health of a person’s immune system. However, studies have shown that approximately 25 to 50 percent of people of African descent have benign ethnic neutropenia, a condition that lowers their ANC levels, but does not affect their immune system. Meanwhile, black patients also tend to have higher sCr concentrations than white patients or patients of other races or ethnicities.

The study revealed nearly 47.9 percent of the clinical trials used sCR alone or required people to have certain levels of ANC which disproportionately excluded black men from clinical trials. This means black patients were excluded from trials despite having healthy immune systems. ‘Adjusting for race-based differences in clinical trial eligibility criteria may add slight logistical challenges, but these adjustments could prevent qualifying individuals from being excluded from trials solely because of laboratory differences caused by their race,’ said lead author Marie Vastola.

This isn’t the first study to reveal certain groups of people are underrepresented in clinical trials. A 2017 study presented at the 10th AACR Conference found are ethnic minority groups and elderly Americans are underrepresented in clinical trials. They found that of the publicly and privately supported clinical trials that took place between 2003 to 2016, 83 percent of patients were white, six percent were African American, 5.3 percent were Asian, 2.6 percent were Hispanic, and 2.4 percent were classified as ‘other.’ Meanwhile, patients age 65 and older represented 36 percent of the patients enrolled in clinical trial.

Prostate cancer, which affects approximately one in every nine men, develops mainly in older men and in African American men, according to the American Cancer Society. African American men are more than 1.6 times more likely to develop prostate cancer than whites and 2.6 times more likely than Asian Americans, according to Harvard Medical school. Symptoms of the disease include difficulty urinating, weak or interrupted flow of urine, blood in the urine or semen, and persistent pain in the back, urine or hips.

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By Jaleesa Baulkman For,

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