It has been recently demonstrated that the androgen receptor functions as a ligand-dependent transcriptional regulator, and that this regulation is important in controlling prostate growth and apoptosis. Heightened androgenic stimulation, a potential by-product of shortened CAG repeat length, could potentially increase the risk of prostate cancer development and progression. In particular, a shorter CAG repeat sequence may be associated with cancers that have features of higher histologic grade, extraprostatic extension, and distant metastases (stage C or D). Recent evidence indicates that men with shorter CAG repeats are at particularly higher risk for distant metastatic and fatal prostate cancer. The results demonstrated that a shorter CAG repeat sequence in the androgen receptor gene predicted higher grade and advanced state of prostate cancer at diagnosis, metastatic disease, and mortality. However, these studies have been limited to whites since only a small number of African American men with prostate cancer were included.