Page 70 - University of Pretoria RESEARCH REVIEW 2016

HEALTH
CANCER GENETICS
IDENTIFYING INDIGENOUS RISK DOMAINS
It is estimated that among South African men, at least one in every 23 will develop prostate cancer in their lifetime, and that prostate-related deaths will double in sub-Saharan Africa by 2030.
Three risk factors for prostate cancer have been validated in clinical trials: ancestry, age and family history. Yet scientists still know very little about
the reasons for a disparity in the risk profile and incidence of prostate cancer in Africa, and in sub- Saharan Africa in particular, compared to other regions. In the western world, prostate cancer has the highest incidence of all male-associated cancers and the second highest mortality rate. In African countries, including South Africa, the incidence of this type of cancer among non-migrant Africans
is uncertain, but a trend towards patients being diagnosed at an earlier age has been observed. Confounding the complexity of this disease is the fact that the incidence and mortality rates are dramatically masked by the impact of infectious diseases on the average life expectancy of South African men.
Professor Riana Bornman, Senior Research Professor in the School of Health Systems and Public Health at UP’s Faculty of Health Sciences, has been involved
in prostate cancer research for several years, specifically among African men. Her research and clinical work has spanned several urban and rural areas in South Africa. In her view, understanding the drivers of this disease remains one of the biggest clinical challenges.
Since 2008, Professor Bornman has collaborated with Professor Vanessa Hayes, Head of the Human Comparative and Prostate Cancer Genomics
Laboratory at the Garvan Institute, Australia. Prof Hayes also holds an extraordinary professorship at the School of Health Systems and Public Health at UP. They are working on the first comprehensive next-generation mapping of an entire prostate cancer genome and expect to find novel genomic rearrangements that were not possible with previous technology. Their hope is that the outcomes of
the study will have clinical potential for prognosis, diagnosis and therapeutics, and eventually help to define African-specific risk areas and the genomic signature of prostate cancer in South African men.
What is urgently required are biomarkers of specifically aggressive prostate cancer disease tailored for South Africa and sub-Saharan Africa;
and further, to extend research linkages to other countries in Africa. If both environmental and genetic factors are contributors to susceptibility and disease course, and specific risk domains are found, then the question becomes what can and must be done?
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