In collaboration with the University of Ghana, NCI is conducting a study to characterize the burden of prostate cancer in Ghana, a country in West Africa whose men are genetically closely related to African Americans, by using state-of-the-art screening protocols. This study has two components: a clinical survey to estimate the incidence of clinical prostate cancer in Accra and a population screening survey to estimate the prevalence of prostate cancer in the male Accra population. The clinical component of the study included the collection of clinical and pathological data for the more than 600 prostate cancer cases diagnosed over the last five years, and case recruitment is complete. The population component of the study screened over 1,000 healthy men, using serum prostate specific antigen testing and digital rectal examination, followed by biopsy confirmation as required. Biopsies revealed that 76 of the men had cancer, and the high prevalence rate suggested that Africans do not have a significantly lower occurrence of prostate cancer than African Americans. Additional research is ongoing. Serum, plasma, and tissue samples from cases are being used in genome-wide association and other studies to better understand the genetic and other determinants of prostate cancer.