The degree of differentiation of 670 blacks and white patients treated from 1980-1990 for curative and palliative external beam radiation therapy and surgery at State University of New York Health Science Center at Brooklyn and Kings County Hospital were analyzed retrospectively, stratified according to race, age, smoking, and grade. In addition stage, birth place and median survival were also analyzed. Overall mean age was 69 years (Std. Dev. 8.97). 69% were blacks and 27.8% were whites. 65.4% were smokers and 34.6% were non-smokers. Smokers had high incidence of more invasive and high grade adenocarcinoma of prostate (p < or = 0.00005) compared to control group (non-smokers with prostate carcinoma). Statistically significant difference was found in the degree of differentiation of carcinoma of prostate in smokers compared to non-smokers. Smokers had 15.04% well, 27.07% moderate, and 57.89% poorly differentiated adenocarcinoma compared to non-smokers in which 37.1% were well, 45.16% moderate, and 17.74% poorly differentiated cancer of prostate (p < or = 0.00005). Sixty-three percent blacks and 40.16% whites had Stage D cancer (p < or = 0.00005). 68.3% smokers and 53.3% non-smokers had Stage D cancer (p = 0.01). Overall median survival for blacks was 74.04 months compared to whites of 115.73 months (p < or = 0.00005).