# Differences in prostate cancer genomes by self-reported race

Source: https://onco.cc/key-papers/paper-stopsack-prostate-genomes-by-race-ccr-2022/  
OnCo record `paper-stopsack-prostate-genomes-by-race-ccr-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Comparing the tumours of 2,069 men treated at one hospital found real genomic differences by race that survived adjusting for stage and PSA, including more of the chromosome change that carries the worst prognosis in Black men.

## Summary

Among 2,069 men with prostate cancer with access to clinical-grade sequencing at the same cancer centre, 1,841 self-reported White, 63 Asian and 165 Black, the prevalence of tumour and germline alterations was assessed in driver genes previously reported to differ by race. Clinical characteristics including PSA, age at diagnosis and cancer stage at sample procurement differed by self-reported race, but most genomic differences persisted after adjustment. Tumours from Black men carried fewer PTEN mutations and more AR alterations than those from White men; tumours from Asian men carried more FOXA1 mutations and more ZFHX3 alterations. Despite fewer TP53 mutations, tumours from Black men had more aneuploidy, particularly gains of chromosome arm 8q, an adverse prognostic factor. Genetic ancestry was associated with similar tumour alterations to self-reported race but also with modifiable cancer risk factors, and community-level average income was associated with 8q gain after adjusting for race and ancestry.

## Fields

- Kind: Key paper
- Last checked: 2026-09-25
- Journal: Clinical Cancer Research
- Year: 2022
- DOI: 10.1158/1078-0432.CCR-21-2577
- Authors: Stopsack KH, Nandakumar S, Arora K, et al.
- Findings: Fewer PTEN mutations and more AR alterations in tumours from Black men after adjustment.; More FOXA1 mutations and ZFHX3 alterations in tumours from Asian men.; More aneuploidy and specifically more 8q gain in tumours from Black men, despite fewer TP53 mutations.; Community-level average income associated with 8q gain even after adjusting for race and genetic ancestry.
- What it means: It separates two explanations that are usually run together. Some of the difference in prostate cancer outcomes by race is in the tumour genome and persists when access to the same centre is held constant, and some of it tracks with income rather than with ancestry, so equalising access alone would not eliminate the gap.
- Caveats: One hundred and sixty-five Black men and 63 Asian men, so the minority groups are small.; A single centre whose patients have unusual access to sequencing.; Self-reported race and genetic ancestry are different variables and the paper is careful not to conflate them; readers often do.

## Sources

- Stopsack et al., Clin Cancer Res 2022: differences in prostate cancer genomes by self-reported race in 2,069 men sequenced at one centre: https://doi.org/10.1158/1078-0432.CCR-21-2577
- PubMed: https://pubmed.ncbi.nlm.nih.gov/34667026/
- cBioPortal study prad_msk_stopsack_2021 (MSK-IMPACT, Clin Cancer Res 2022; 2,069 men with self-reported race recorded, 1,841 White, 165 Black, 63 Asian): https://www.cbioportal.org/study/summary?id=prad_msk_stopsack_2021

## Connected records

- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Comprehensive genomic profiling](https://onco.cc/technologies/cgp/)
- targets: [Androgen receptor](https://onco.cc/targets/androgen-receptor/), [FOXA1](https://onco.cc/targets/foxa1/), [PTEN](https://onco.cc/targets/pten/), [TP53](https://onco.cc/targets/tp53/), [ZBTB16](https://onco.cc/targets/zbtb16/)
- pathways: [Androgen receptor signalling](https://onco.cc/pathways/ar-signaling/), [Chromosomal instability & aneuploidy](https://onco.cc/pathways/chromosomal-instability/), [Prostate cancer (KEGG map)](https://onco.cc/pathways/prostate-cancer-signalling/)
- terms: [Copy number alteration (CNA)](https://onco.cc/terms/copy-number-variation-term/), [Driver mutation](https://onco.cc/terms/driver-mutation/)
- journals: [Clinical Cancer Research](https://onco.cc/journals/clinical-cancer-research/)

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