In the USA, Black men are approximately twice as likely to be diagnosed with and to die of prostate cancer than white men. In the UK, despite Black men having vastly different ancestral contexts and health-care systems from Black men in the USA, the lifetime risk of being diagnosed with prostate cancer is two-to-three times higher among Black British men than among white British men and Black British men are twice as likely to die of prostate cancer as white British men. Examination of racial disparities in prostate cancer in the USA and UK highlights systemic, socio-economic and sociocultural factors that might contribute to these differences. Variation by ancestry could affect incidence and tumour genomics. Disparities in incidence might also be affected by screening guidelines and access to and uptake of screening. Disparities in treatment access, continuity of care and outcomes could contribute to survival differences. In both localized and metastatic settings, equal access could diminish the observed disparities in both the USA and the UK. An understanding of behavioural medicine, especially an appreciation of cultural beliefs about illness and treatment, could inform and improve the ways in which health systems can engage with and deliver care to patients in minoritized groups affected by prostate cancer. Methods of promoting equity include targeting systemic barriers including systemic racism, proportional recruitment of patients into clinical trials, diversifying the health-care workforce and facilitating care informed by cultural humility. Actively engaging patients and communities in research and intervention might enable the translation of research into increasingly equitable care for patients with prostate cancer in the UK, the USA and globally.

在美国，黑人男性被诊断出患有前列腺癌和死于前列腺癌的可能性大约是白人男性的两倍。在英国，尽管黑人男性的祖先背景和医疗保健系统与美国黑人男性大不相同，但英国黑人男性被诊断出患有前列腺癌的终生风险是英国白人男性的两到三倍，英国黑人男性死于前列腺癌的可能性是英国白人男性的两倍。对美国和英国前列腺癌种族差异的检查突出了可能导致这些差异的系统性、社会经济和社会文化因素。血统的变异可能会影响发病率和肿瘤基因组学。发病率的差异也可能受到筛查指南以及筛查的可及性和接受度的影响。治疗可及性、护理连续性和结局方面的差异可能导致生存率差异。在局部和转移性环境中，平等可及性可以减少在美国和英国观察到的差异。对行为医学的理解，尤其是对疾病和治疗的文化信仰的理解，可以告知和改进卫生系统与受前列腺癌影响的少数群体患者接触和提供护理的方式。促进公平的方法包括针对系统性障碍，包括系统性种族主义、按比例招募患者参加临床试验、使医护人员多样化以及促进以文化谦逊为依据的护理。积极让患者和社区参与研究和干预，可能会使研究转化为对英国、美国和全球前列腺癌患者越来越公平的护理。