Background: Prostate cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer-related death among men in the U.S. The Bronx has experienced higher PCa incidence and mortality rates than the national average. This study examined trends in PCa incidence and mortality across racial, ethnic, and geographic groups to identify patterns contributing to disparities.

Methods: PCa incidence data (2000–2018) were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program and the New York State Cancer Registry. Population denominators were derived from the 2000 U.S. Census data. Age-adjusted incidence and mortality rates were compared across the U.S., New York State, New York City, and the Bronx, focusing on non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Hispanic men. SEER*Stat software was used to calculate average annual percentage changes (APCs) and 95% CIs to assess trends by race, ethnicity, and region.

Results: While PCa incidence and mortality declined nationally between 2000–2018, decreases were significantly slower in the Bronx. The APC in Bronx PCa incidence was smallest among NHBs and Hispanic men (−2.9; 95% CI: −3.8, −2.1) compared with NHWs (−3.4; 95% CI: −4.6, −2.2). PCa mortality declined more among NHBs (−3.7; 95% CI: −4.0, −3.4) than among NHWs (−2.7; 95% CI: −3.0, −2.4) or Hispanics (−2.6; 95% CI: −2.9, −2.2). A higher proportion of distant-stage PCa occurred in the Bronx during 2014–2018, particularly among NHB and NHW men.

Conclusions: Geographic and racial disparities in PCa persist, with the Bronx disproportionately affected. Elevated PCa rates may reflect the Bronx’s larger male population of African ancestry and structural barriers to timely diagnosis and treatment. Higher mortality among Bronx NHWs may reflect inequities in access to care and underscores the need for improved early detection and post-PCa management. Updated analyses are underway to assess recent regional patterns.