Abstract
BACKGROUND: Immigration of Asians and Hispanics to countries with higher affluence is associated with a marked increase in the incidence of prostate and other cancers. The goal of this review was to understand the genomic mechanism. METHODS: Cancer incidence, mortality, and comorbidities among Asian and Hispanic immigrants in North America and other affluent countries were systematically reviewed. RESULTS: Obesity after approximately 10 years or more of acculturation has dramatically increased to levels in some reports that exceed those of males born in North America. The key gene activities associated with obesity include Insulin, FTO (fat mass and obesity gene), IGF-1, and others, leading to a proinflammatory gene expression profile leading to paracrine factors that act on PCa cells and the tumor microenvironment to promote epithelial-mesenchymal transformation, increased invasion, migration, and metastasis. CONCLUSION: Obesity among immigrant populations provides a natural experiment that associates obesity with specific obesity-linked genes to suggest the mechanisms of increased prostate cancer. IMPACT: Genes associated with obesity are active in periprostatic tissue and promote prostate cancer and progression. Evidence indicates that diet, lifestyle changes, and GLP-1 agonists may be effective therapies with the potential to achieve major medical advances.