scholarly journals Impact of Ethnicity on Primary Treatment Choice and Mortality in Men With Prostate Cancer: Data From CaPSURE

2010 ◽  
Vol 28 (6) ◽  
pp. 1069-1074 ◽  
Author(s):  
Kelvin A. Moses ◽  
Alan T. Paciorek ◽  
David F. Penson ◽  
Peter R. Carroll ◽  
Viraj A. Master
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
African Americans ◽  
African American Men ◽  
White Men ◽  
Primary Treatment ◽  
Risk Level ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
To Receive

Purpose Men diagnosed with prostate cancer have multiple options available for treatment. Previous reports have indicated a trend of differing modalities of treatment chosen by African American and white men. We investigated the role of ethnicity in primary treatment choice and how this affected overall and cancer-specific mortality. Methods By utilizing data abstracted from Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), patients were compared by ethnicity, primary treatment, number of comorbidities, risk level according to modified D'Amico criteria, age, highest educational level attained, type of insurance, treatment facility, and perception of general health. Multinomial logistic regression analysis was performed to determine the effect of the tested variables on primary treatment and mortality. Results African American men were more likely to receive nonsurgical therapy than white men with equivalent disease characteristics. Whites were 48% less likely than African Americans to receive androgen deprivation therapy (ADT) compared with surgery (P = .02) and were 25% less likely than African Americans to receive radiation therapy compared with surgery (P = .08). Whites with low-risk disease were 71% less likely to receive ADT than African American men with similar disease (P = .01). Adjusted overall and prostate cancer–specific mortality were not significantly different between whites and African Americans (hazard ratios, 0.73 and 0.37, respectively). Risk level, type of treatment, and type of insurance had the strongest effects on risk of mortality. Conclusion There is a statistically significant difference in primary treatment for prostate cancer between African American and white men with similar risk profiles. Additional research on the influence of patient/physician education and perception and the role that socioeconomic factors play in mortality from prostate cancer may be areas of focus for public health initiatives.

Effect of healthcare system on prostate cancer-specific mortality in African American and non-Hispanic white men.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 23-23
Author(s):  
Daniella Klebaner ◽  
Patrick Travis Courtney ◽  
Brent S. Rose
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Healthcare System ◽  
Metastatic Disease ◽  
Cumulative Incidence ◽  
African American Men ◽  
White Men ◽  
Cancer Specific Mortality ◽  
Hispanic White

23 Background: Disparities in prostate cancer-specific mortality (PCSM) between African American and non-Hispanic White (White) patients have been attributed to biological differences; however, recent data suggest poorer outcomes may be related to barriers to medical care from the healthcare system in which patients receive care. We sought to evaluate potential drivers of disparities by comparing outcomes between African American and White men in the Surveillance, Epidemiology and End Results (SEER) national cancer registry and a relatively equal-access healthcare system, the Veterans Health Administration (VHA). Methods: We identified African American and White patients diagnosed with prostate cancer between 2004-2015 in the SEER and VHA databases. We analyzed metastatic disease at diagnosis with multivariable logistic regression, and PCSM with cumulative incidence analysis and sequential competing-risks regression adjusting for disease and sociodemographic factors. Results: The SEER cohort included 306,609 men (57,994 [18.9%] African American and 248,615 [81.1%] White) with a median follow-up of 5.3 years (interquartile range [IQR] 2.6-8.1 years), and the VHA cohort included 90,749 men (27,412 [30.2%] African American and 63,337 [69.8%] White) with a median follow-up of 4.7 years (IQR 2.4-7.6 years). In SEER, African American men were significantly more likely to present with metastatic disease (African American 4.3% versus White 3.0%, p< 0.001; multivariable odds ratio [OR] 1.25, 95% confidence interval [CI] 1.19-1.32, p< 0.001), whereas in the VHA, African American men were not significantly more likely to present with metastatic disease (African-American 3.2% versus White 3.3%, p= 0.26; multivariable OR 1.07, 95% CI 0.98-1.17, p= 0.12). In SEER, the 8-year cumulative incidence of PCSM was significantly higher for African American compared with White men (6.9% versus 5.1%, p< 0.001), whereas in the VHA, African American compared with White men did not have a significantly higher 8-year cumulative incidence of PCSM (5.5% versus 5.4%, p= 0.93). African American race was significantly associated with an increased risk of PCSM in SEER (univariable subdistribution hazard ratio [SHR] 1.39, 95% CI 1.33-1.45, p< 0.001), but was not significantly associated with PCSM on uni- and multivariable regression in the VHA. When adjusted for disease characteristics at diagnosis in SEER, disease extent, PSA, and Gleason score contributed to 85% of the risk of PCSM for African American men (adjusted SHR 1.06, 95% CI 1.02-1.12, p= 0.008). Conclusions: Racial disparities in PCSM were present in a national cohort, SEER, but not as pronounced in a relatively equal-access healthcare system, the VHA, potentially due to differences in metastatic disease at diagnosis among African American and White men between cohorts. These findings may be attributable to reduced barriers to care in the VHA.

scholarly journals African-American men and prostate cancer-specific mortality: a competing risk analysis of a large institutional cohort, 1989-2015

2018 ◽  
Vol 7 (5) ◽  
pp. 2160-2171 ◽  
Author(s):  
Vonetta L. Williams ◽  
Shivanshu Awasthi ◽  
Angelina K. Fink ◽  
Julio M. Pow-Sang ◽  
Jong Y. Park ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Risk Analysis ◽  
African American Men ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Duffy Antigen/Receptor for Chemokines (DARC): Is There a Role in Prostate Cancer?.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4394-4394
Author(s):  
Samuel B. Anyona ◽  
Shiyan Zheng ◽  
Thomas Wheeler ◽  
Michael Ittmann ◽  
Teresa G. Hayes ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
African Americans ◽  
African American Men ◽  
Rapid Development ◽  
Antigen Receptor ◽  
Taqman Assay ◽  
Blood Group Antigens ◽  
Duffy Antigen ◽  
Duffy Negative

Abstract Introduction: The Duffy blood group antigens function as chemokine receptors and as receptors for several species of malarial parasites. Approximately 70% of African Americans are Duffy negative as a result of a single nucleotide polymorphism in the promoter region of the Duffy antigen/receptor for chemokines (DARC) gene in a consensus-binding site for GATA 1. This mutation abolishes the promoter activity in erythrocytes, impairing the expression of DARC on red blood cells. Other than resistance to certain species of malaria, the functional consequence of Duffy negativity is unclear; however, it has recently been proposed that the Duffy antigen acts as a biological ‘sink’ to clear pro-inflammatory chemokines from tissue microcirculation. Further it has been suggested that since the incidence of prostate cancer in African Americans is 60% higher than in Caucasians, absence of the Duffy antigen might predispose African Americans to prostate cancer by impairing downregulation of proinflammatory cytokines. We tested the hypothesis that lack of expression of DARC on erythrocytes predisposes African American men to develop prostate cancer. Methods: We conducted a case control study of 89 African American men with confirmed prostate cancer and 51 age matched healthy African American men. The samples were genotyped for the promoter polymorphism using an allele specific real time PCR assay (Taqman assay) developed for this study. Results: The frequency of the Duffy negative allele was 75.8% among the patients and 81.4% among the controls (odds ratio = 0.72, p value = 0.28). The distribution of heterozygous and homozygous Duffy negative patients did not differ between the cases and controls. Conclusion: It has been suggested that individuals lacking erythrocyte expression of DARC have higher prostate levels of angiogenic chemokines that might promote more rapid development of prostate cancer. The data presented here found no difference in the frequency of the Duffy negative allele between African American men with prostate cancer and healthy age matched African American controls. Since several studies suggest that polymorphisms associated with differential production of IL-8, IL-10 and VEGF are risk factors for prostate cancer, it remains possible that a polymorphism associated with differential cytokine production in combination with Duffy negativity increases the risk for prostate cancer.

scholarly journals Epigenome-Wide Association Study of Prostate Cancer in African Americans Identifies DNA Methylation Biomarkers for Aggressive Disease

Biomolecules ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1826
Author(s):  
Yifan Xu ◽  
Chia-Wen Tsai ◽  
Wen-Shin Chang ◽  
Yuyan Han ◽  
Maosheng Huang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Dna Methylation ◽  
African American ◽  
African Americans ◽  
Zinc Finger Protein ◽  
African American Men ◽  
Pathway Enrichment Analysis ◽  
Cpg Sites ◽  
Differentially Methylated Genes ◽  
Incidence And Mortality

DNA methylation plays important roles in prostate cancer (PCa) development and progression. African American men have higher incidence and mortality rates of PCa than other racial groups in U.S. The goal of this study was to identify differentially methylated CpG sites and genes between clinically defined aggressive and nonaggressive PCa in African Americans. We performed genome-wide DNA methylation profiling in leukocyte DNA from 280 African American PCa patients using Illumina MethylationEPIC array that contains about 860K CpG sties. There was a slight increase of overall methylation level (mean β value) with the increasing Gleason scores (GS = 6, GS = 7, GS ≥ 8, P for trend = 0.002). There were 78 differentially methylated CpG sites with P < 10−4 and 9 sites with P < 10−5 in the trend test. We also found 77 differentially methylated regions/genes (DMRs), including 10 homeobox genes and six zinc finger protein genes. A gene ontology (GO) molecular pathway enrichment analysis of these 77 DMRs found that the main enriched pathway was DNA-binding transcriptional factor activity. A few representative DMRs include HOXD8, SOX11, ZNF-471, and ZNF-577. Our study suggests that leukocyte DNA methylation may be valuable biomarkers for aggressive PCa and the identified differentially methylated genes provide biological insights into the modulation of immune response by aggressive PCa.

Impact of Race on Prostate-Specific Antigen Outcome After Radical Prostatectomy for Clinically Localized Adenocarcinoma of the Prostate

2002 ◽  
Vol 20 (12) ◽  
pp. 2863-2868 ◽  
Author(s):  
Chaundre K. Cross ◽  
Delray Shultz ◽  
S. Bruce Malkowicz ◽  
William C. Huang ◽  
Richard Whittington ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
High Risk ◽  
Gleason Score ◽  
Risk Group ◽  
African American Men ◽  
Specific Antigen ◽  
White Men ◽  
Risk Groups ◽  
T Stage

PURPOSE: To compare prostate-specific antigen (PSA) outcome after radical prostatectomy (RP) for prostate cancer in African-American and white men using previously established risk groups. PATIENTS AND METHODS: Between 1989 and 2000, 2,036 men (n = 162 African-American men, n = 1,874 white men) underwent RP for clinically localized prostate cancer. Using pretreatment PSA, Gleason score, clinical T stage, and percentage of positive biopsy specimens, patients were stratified into low- and high-risk groups. For each risk group, PSA outcome was estimated using the actuarial method of Kaplan and Meier. Comparisons of PSA outcome between African-American and white men were made using the log-rank test. RESULTS: The median age and PSA level for African-American and white men were 60 and 62 years old and 8.8 and 7.0 ng/mL, respectively. African-Americans had a statistically significant increase in PSA (P = .002), Gleason score (P = .003), clinical T stage (P = .004), and percentage of positive biopsy specimens (P = .04) at presentation. However, there was no statistical difference in the distribution of PSA, clinical T stage, or Gleason score between racial groups in the low- and high-risk groups. The 5-year estimate of PSA outcome was 87% in the low-risk group for all patients (P = .70) and 28% versus 32% in African-American and white patients in the high-risk group (P = .28), respectively. Longer follow-up is required to confirm if these results are maintained at 10 years. CONCLUSION: Even though African-American men presented at a younger age and with more advanced disease compared with white men with prostate cancer, PSA outcome after RP when controlled for known clinical predictive factors was not statistically different. This study supports earlier screening in African-American men.

scholarly journals Prostate Cancer Incidence Rates in Africa

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa W. Chu ◽  
Jamie Ritchey ◽  
Susan S. Devesa ◽  
Sabah M. Quraishi ◽  
Hongmei Zhang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
African Americans ◽  
Cancer Incidence ◽  
African American Men ◽  
Population Based ◽  
Incidence Rates ◽  
International Agency ◽  
Prostate Cancer Incidence ◽  
Cancer Incidence Rates

African American men have among the highest prostate cancer incidence rates in the world yet rates among their African counterparts are unclear. In this paper, we compared reported rates among black men of Sub-Saharan African descent using data from the International Agency for Research on Cancer (IARC) and the National Cancer Institute Surveillance, Epidemiology, and End Results Program for 1973–2007. Although population-based data in Africa are quite limited, the available data from IARC showed that rates among blacks were highest in the East (10.7–38.1 per 100,000 man-years, age-adjusted world standard) and lowest in the West (4.7–19.8). These rates were considerably lower than those of 80.0–195.3 observed among African Americans. Rates in Africa increased over time (1987–2002) and have been comparable to those for distant stage in African Americans. These patterns are likely due to differences between African and African American men in medical care access, screening, registry quality, genetic diversity, and Westernization. Incidence rates in Africa will likely continue to rise with improving economies and increasing Westernization, warranting the need for more high-quality population-based registration to monitor cancer incidence in Africa.

scholarly journals Do African American Men Have Lower Survival From Prostate Cancer Compared With White Men? A Meta-analysis

2010 ◽  
Vol 4 (3) ◽  
pp. 189-206 ◽  
Author(s):  
Gayathri Sridhar ◽  
Saba W. Masho ◽  
Tilahun Adera ◽  
Viswanathan Ramakrishnan ◽  
John D. Roberts
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Racial Differences ◽  
African American Men ◽  
Meta Analysis ◽  
White Men ◽  
Cancer Specific Survival ◽  
Increased Risk ◽  
Significant Difference ◽  
The Relationship

Prostate cancer is the second leading cause of cancer-related mortality in men. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of articles published from 1968 to 2007 assessing survival from prostate cancer was conducted. Analysis of unadjusted studies reported that African American men have an increased risk of all-cause mortality (hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.31-1.65, p < .001). However, examination of adjusted studies identified no difference (HR = 1.07, 95% CI = 0.94-1.22, p = .308). No statistically significant difference was observed in prostate cancer—specific survival in both analyses using unadjusted (HR = 1.11, 95% CI = 0.94-1.31, p = .209) and adjusted studies (HR = 1.15, 95% CI = 0.95-1.41, p = .157). This meta-analysis concludes that there are no racial differences in the overall and prostate cancer—specific survival between African American and White men.

scholarly journals African-American men with nonpalpable prostate cancer exhibit greater tumor volume than matched white men

Cancer ◽  
2006 ◽  
Vol 107 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Ricardo F. Sanchez-Ortiz ◽  
Patricia Troncoso ◽  
Richard J. Babaian ◽  
Josep Lloreta ◽  
Dennis A. Johnston ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Tumor Volume ◽  
African American Men ◽  
White Men

The socioeconomic attainments of second-generation Nigerian and other African Americans: Evidence from the Current Population Survey, 2009-2018

2019 ◽  
Author(s):  
Arthur Sakamoto ◽  
Ernesto F. L. Amaral ◽  
Sharron Xuanren Wang ◽  
Courtney Nelson
Keyword(s):  
African American ◽  
African Americans ◽  
Educational Attainment ◽  
Current Population Survey ◽  
Population Survey ◽  
Second Generation ◽  
African American Men ◽  
White Men ◽  
American Women ◽  
Current Population

Using recent data from the Current Population Survey, we investigate education and wages among second-generation African Americans with a focus on Nigerian Americans. The results indicate that the educational attainment of second-generation Nigerian Americans exceeds other second-generation African Americans, third-and-higher generation African Americans, third-and-higher generation whites, and second-generation whites. The educational attainment of second-generation Nigerian American women furthermore exceeds second-generation Asian American women. After controlling for age, education and disability, the wages of second-generation Nigerian American women have reached parity with third-and-higher generation white women whereas third-and-higher generation African American women have about 11 percent lower wages. After controlling for age, education and disability in the case of men, the wages of second-generation Nigerian American men have reached parity with third-and-higher generation white men whereas third-and-higher generation African American men have about 21 percent lower wages while other second-generation African American men have about 12 percent lower wages than third-and-higher generation white men. Contrary to the usual pattern of socioeconomic disadvantage for African Americans, these results indicate that second-generation Nigerian Americans have exceeded whites in educational attainment and have reached parity with equally-educated whites in terms of wage determination among employed workers. Nonetheless, we view our results as being only suggestive and call for more research on the socioeconomic outcomes of second-generation African Americans who have been relatively neglected in immigration studies.

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