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This review explores the multifactorial underpinnings of these disparities, integrating genomic, socioeconomic, environmental, and systemic contributors. Genomic analyses reveal that AA men harbor distinct molecular alterations, including higher frequencies of FOXA1, BRAF, and CHD1 mutations, as well as DNA damage repair defects, highlighting the critical need for population\u2010specific precision medicine. Immune\u2010oncologic pathways and stromal interactions within the tumor microenvironment further underscore biological differences driving aggressive disease phenotypes. Concurrently, adverse social determinants\u2014including limited access to care, lower PSA screening rates, delayed treatment, medical mistrust, and underrepresentation in clinical trials\u2014contribute to poorer outcomes. Despite these challenges, evidence from equal\u2010access healthcare systems indicates that when provided equitable treatment, AA men can achieve outcomes comparable to or better than their CA counterparts. This review emphasizes actionable strategies to reduce disparities, including increasing AA representation in clinical trials, enhancing culturally competent patient\u2010provider communication, improving access to early detection and high\u2010quality care, and expanding community\u2010based outreach initiatives. A holistic, interdisciplinary approach is essential to dismantle systemic barriers and achieve health equity in prostate cancer outcomes.<\/jats:p>","DOI":"10.1002\/cam4.70979","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T09:53:57Z","timestamp":1748598837000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Understanding Racial Disparities in Prostate Cancer: A Multifaceted Approach"],"prefix":"10.1002","volume":"14","author":[{"suffix":"IV","given":"Charles","family":"Cobbs","sequence":"first","affiliation":[{"name":"Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory T.","family":"Chesnut","sequence":"additional","affiliation":[{"name":"Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Urology Service, Department of Surgery Walter Reed National Military Medical Center  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0335-638X","authenticated-orcid":false,"given":"Ayesha A.","family":"Shafi","sequence":"additional","affiliation":[{"name":"Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Henry M. 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