For months, Morgan County District Attorney Scott Anderson carried a diagnosis that thousands of Alabama families will confront this year: prostate cancer.
Anderson’s battle became public on September 7, when WAFF 48 reported that he had been diagnosed in January after a routine prostate-specific antigen, or PSA, blood test. He told the station he had no physical symptoms. Additional testing later showed the cancer was aggressive, and he underwent surgery in May. His follow-up PSA test showed no detectable cancer.
His experience is more than a personal story. It illustrates a larger Alabama health crisis, particularly for Black men, whose risk of developing and dying from prostate cancer is dramatically higher.
According to the Alabama Department of Public Health’s Alabama Cancer Statistics 2026 report, an estimated 5,400 Alabama men will be diagnosed with prostate cancer this year and about 560 will die from it. The statewide incidence rate is 118.2 cases per 100,000 men, but the racial divide is striking: 184.8 per 100,000 Black men compared with 95.4 among White men. The mortality rate is 39.6 per 100,000 Black men compared with 16.9 for White men.
That means Black Alabama men are diagnosed at nearly twice the rate of White men and die from the disease at more than twice the rate.
The problem extends across the South. American Cancer Society 2026 projections estimate 11,420 new prostate cancer cases in Georgia, 7,190 in Tennessee, 5,440 in Louisiana, 5,400 in Alabama and 3,170 in Mississippi. Those five states alone account for about 32,620 projected diagnoses. Florida adds another 26,970.
Nationally, the American Cancer Society estimates 333,830 new prostate cancer cases and 36,320 deaths in 2026. About one in eight men will be diagnosed with prostate cancer during his lifetime. U.S. incidence rose about 3% per year from 2014 through 2022, with concern growing over increases in advanced-stage disease.
For Black men, the national picture is especially troubling. The American Cancer Society reports that Black men are about 70% more likely to develop prostate cancer than White men and are about twice as likely to die from it. Prostate cancer also tends to occur at younger ages in Black men.
Researchers continue to examine genetics, tumor biology and inherited risks such as BRCA mutations. But access to preventive care, timely diagnosis, follow-up testing and high-quality treatment also shape outcomes. In communities where men delay care because of cost, transportation, mistrust or lack of a regular healthcare provider, a silent cancer can gain valuable time.
That is why the question should not simply be, “Do I have symptoms?”
Early prostate cancer often causes none. When symptoms do occur, they can include difficulty urinating, a weak urine stream, frequent nighttime urination, blood in the urine or semen, and persistent pain in the back, hips or pelvis. Those symptoms can also be caused by noncancerous conditions, so medical evaluation is important.
The American Cancer Society recommends informed conversations about screening beginning at age 50 for men at average risk who are expected to live at least 10 more years. The discussion should begin at age 45 for men at high risk, including men of African ancestry and men with a father or brother diagnosed before age 65. Men at even higher risk should begin the conversation at age 40.
Screening decisions should be made with a healthcare provider because PSA testing has both benefits and limitations. A high PSA level does not automatically mean cancer, and some prostate cancers grow so slowly that treatment may not be necessary. But finding an aggressive cancer before it spreads can change the outcome dramatically.
For Alabama men without easy access to testing, help is available. The Alabama Department of Public Health lists partners offering free prostate cancer screenings for men ages 40 to 75, including Central North Alabama Health Services in Huntsville.
September is Prostate Cancer Awareness Month, but the message for Alabama men should last far beyond one month: know your family history, know your risk, and talk with a healthcare provider before symptoms force the conversation.
For Black men especially, early discussion and informed screening may help turn a silent threat into a cancer that is found while there is still time to fight it.
