The identification of novel African-specific prognostic, including PTPRD, LSAMP, PACRG, FBXO7, GTF3C2 and NTNG1, and therapeutic targets, including CADM2, PDE4D and YPEL5, emphasises the need for both African inclusion and SV interrogation to reduce advanced PCa ethnic disparity through tailored clinical management. Here, PDE4D is linked to posterior cortical atrophy.