Racial disparities in late-stage prostate cancer: A SEER database analysis 2005–2015.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 115-115 ◽  
Author(s):  
Jianqing Lin ◽  
Stephanie Rodriguez ◽  
Hanbing Zhou ◽  
Andrew D Sparks ◽  
Samuel J. Simmens ◽  
...  

115 Background: Incidence of metastatic prostate cancer in U.S. males has increased over the past ten years, but it is unknown how this trend varies over time within different racial and ethnic populations. Methods: We identified all men first diagnosed with prostate cancer from 2005-2015 in the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, which monitors 18 population-based cancer registries. Yearly cancer diagnosis frequency from 2005 to 2015 was categorized and analyzed by stage (in situ/localized, regional, and distant), race/ethnicity [White, Asian American/Pacific Islander (AAPI), Black], and age group (45-54, 55-69, 70-75). Chi-square tests, multivariable logistic regression models were used for data analysis with p < 0.05 considered significant. Results: In the 10-year study period, the proportion of regional-stage prostate cancer increased from 14.2% to 16.6% of cases (p < .0001) and distant-stage increased from 3.3% to 5.8% (p < .0001). The odds of being diagnosed with regional-stage prostate cancer in 2013-2015 compared to 2005-2008 were 1.3 times higher for Black men (95% CI: 1.2-1.5), 1.3 times higher for AAPI men (95% CI: 1.1-1.5), and 1.2 times higher for White men (95% CI: 1.2-1.3). The odds of being diagnosed with distant-stage prostate cancer in 2013-2015 compared to 2005-2008 were 1.6 times higher for Black men (95% CI: 1.4-1.9), 1.8 times higher for AAPI men (95% CI: 1.5-2.3), and 2.1 times higher for White men (95% CI: 1.9-2.2). Conclusions: The incidence of late-stage prostate cancer has increased significantly in all US male despite race and ethnicity. However, reginal-stage prostate cancer increased the most over time in AAPI and Black men, while newly-diagnosed distant prostate cancer increased the most over time in White men.

2006 ◽  
Vol 6 ◽  
pp. 2460-2470 ◽  
Author(s):  
Steven T. Fleming ◽  
Kathleen McDavid ◽  
Kevin Pearce ◽  
Dmitri Pavlov

The degree to which comorbidities affect the diagnosis of prostate cancer is not clear. The purpose of this study was to determine how comorbidities affect the stage at which prostate cancer is diagnosed in elderly white and black men. We obtained data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute merged with Medicare claims data. For each patient, we estimated associations between stage of disease at diagnosis and each of the 27 comorbidities. The sample included 2,489 black and 2,587 white men with staged prostate cancer. Coronary artery disease, benign hypertension, and dyslipidemia reduced the odds of late-stage prostate cancer. A prior diagnosis of peripheral vascular disease, severe renal disease, or substance abuse increased the odds of being diagnosed with late-stage disease. The study shows some effect modification by race, particularly among white men with substance abuse, cardiac conduction disorders, and other neurologic conditions. The strongest predictors of late-stage prostate cancer diagnosis for both white and black men were age at diagnosis of at least 80 years and lack of PSA screening. Comorbidities do affect stage at diagnosis, although in different ways. Four hypotheses are discussed to explain these findings.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthias E. Meunier ◽  
Pascal Blanchet ◽  
Yann Neuzillet ◽  
Thierry Lebret ◽  
Laurent Brureau

Abstract Background Prostate cancer among black men is known to have specific molecular characteristics, especially the androgen receptor or enzymes related to the androgen metabolism. These targets are keys to the action of new hormonal therapies. Nevertheless, literature has a lack of data regarding black men. We aimed to gather the available literature data on new hormonal therapies among black populations. Methods We conducted a literature review from the PubMed / MEDLINE database until October 2020. All clinical studies of new hormonal therapies and black populations, regardless of methodology, were included. Results Four studies provided data on new hormonal therapies in black populations. Three studies reported a PSA decline in black patients treated with Abiraterone, higher in black men than in white men. Overall survival also appears to be higher in black patients treated with Abiraterone only or first. Conclusion Few articles have evaluated the effectiveness and safety of use of these treatments among black populations. The first results seem to show that Abiraterone can provide a benefit in overall survival in black populations. Prospective studies are needed to answer these questions in the future.


2012 ◽  
Vol 38 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Frederico R. Romero ◽  
Antonio W. Romero ◽  
Rui Manuel S. de Almeida ◽  
Renato Tambara Filho

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Bannour ◽  
I Zemni ◽  
C Ben Nasrallah ◽  
N Aroua ◽  
M Kacem ◽  
...  

Abstract Introduction Cancer is an eminent public health issue in the developing countries. The risk factors incriminated in cancer higher incidence are multiple such as the growing population rates, increasing tobacco consumption, the changes of diet and lifestyle. In Tunisia, there are three population-based cancer registries at the present time providing data on cancer incidence and survival. According to the data published by WHO International Agency for Research on Cancer (IACR) (GLOBOCAN 2018), prostate cancer in Tunisia ranks fifth among cancers with almost 819 new cases per year. The aim of this study was to we report trends in the cancer incidence during the span of time between 2002 and 2013 from the population-based cancer registry of the centre of Tunisia, and to predict the future number of cancer cases by 2030. Methods The cancer incidence data were collected from the Center cancer registries from 2003 to 2012.The data were stratified by cancer site, sex and age. We used SPSS software in order to calculate the crude incidence rates and age-standardized incidence rates. SPSS software was used in order to estimate the future number of cancer cases by 2030. Results A total of 725 cases of prostate cancer were enregistrated. The mean age of patients was 71.6 ±10.61years. The crude incidence rates were estimated 23.537. The standardized incidence rate was 33.92. A significant positive trend was noted with a b = 0133 and p &lt; 10-3. 1033 new cases are predicted by 2030 Conclusions The data of the cancer register of the center shows that the incidence of cancer is rising, and it is consistent with the National cancer intelligence, but some cancer incidence showed slightly higher, such as thyroid cancer and prostate cancer. In order to face this alarming situation, many preventive steps should be done such as strengthening early screening and diagnosis of cancer, improving clinical research in order to better control the risks factors. Key messages Prediction of the future number of cancer cases is of great interest to society. Prostate cancer in Tunisia ranks fifth among cancers.


2019 ◽  
Vol 37 (5) ◽  
pp. 403-410 ◽  
Author(s):  
Susan Halabi ◽  
Sandipan Dutta ◽  
Catherine M. Tangen ◽  
Mark Rosenthal ◽  
Daniel P. Petrylak ◽  
...  

Purpose Several studies have reported that among patients with localized prostate cancer, black men have a shorter overall survival (OS) time than white men, but few data exist for men with advanced prostate cancer. The primary goal of this analysis was to compare the OS in black and white men with metastatic castration-resistant prostate cancer (mCRPC) who were treated in phase III clinical trials with docetaxel plus prednisone (DP) or a DP-containing regimen. Methods Individual participant data from 8,820 men with mCRPC randomly assigned in nine phase III trials to DP or a DP-containing regimen were combined. Race was based on self-report. The primary end point was OS. The Cox proportional hazards regression model was used to assess the prognostic importance of race (black v white) adjusted for established risk factors common across the trials (age, prostate-specific antigen, performance status, alkaline phosphatase, hemoglobin, and sites of metastases). Results Of 8,820 men, 7,528 (85%) were white, 500 (6%) were black, 424 (5%) were Asian, and 368 (4%) were of unknown race. Black men were younger and had worse performance status, higher testosterone and prostate-specific antigen, and lower hemoglobin than white men. Despite these differences, the median OS was 21.0 months (95% CI, 19.4 to 22.5 months) versus 21.2 months (95% CI, 20.8 to 21.7 months) in black and white men, respectively. The pooled multivariable hazard ratio of 0.81 (95% CI, 0.72 to 0.91) demonstrates that overall, black men have a statistically significant decreased risk of death compared with white men ( P < .001). Conclusion When adjusted for known prognostic factors, we observed a statistically significant increased OS in black versus white men with mCRPC who were enrolled in these clinical trials. The mechanism for these differences is not known.


1995 ◽  
Vol 87 (5) ◽  
pp. 354-359 ◽  
Author(s):  
A. S. Whittemore ◽  
C. Lele ◽  
G. D. Friedman ◽  
T. Stamey ◽  
J. H. Vogelman ◽  
...  

2020 ◽  
Author(s):  
Igor Vidal ◽  
Qizhi Zheng ◽  
Jessica L. Hicks ◽  
Jiayu Chen ◽  
Elizabeth A. Platz ◽  
...  

GSTP1 is a member of the Glutathione-S-transferase (GSTS) family silenced by CpG island DNA hypermethylation in 90-95% of prostate cancers. However, prostate cancers expressing GSTP1 have not been well characterized. We used immunohistochemistry against GSTP1 to examine 1673 primary prostatic adenocarcinomas on TMAs with redundant sampling from the index tumor from prostatectomies. GSTP1 protein was positive in at least one TMA core in 7.7% of cases and in all TMA cores in 4.4% of cases. The percentage of adenocarcinomas from Black patients who had any GSTP1 positive TMA cores was 14.9%, which was 2.5 times higher than the percentage from White patients (5.9%; P < 0.001). Further, the percentages of tumors from Black patients who had all TMA spots positive for GSTP1 (9.5%) was 3-fold higher than the percentage from White patients (3.2%; P<0.001). The increased percentage of GSTP1 positive cases in Black men was present only in ERG positive cases. By in situ hybridization, GSTP1 mRNA expression was concordant with protein staining, supporting the lack of silencing of at least some GSTP1 alleles in GSTP1-positive tumor cells. This is the first report revealing that the GSTP1-positive prostate cancer subset is substantially over-represented among prostate cancers from Black compared to White men. This observation should prompt additional studies to determine whether GSTP1 positive cases represent a distinct molecular subtype of prostate cancer and whether GSTP1 expression could provide a biological underpinning for the observed disparate outcomes for Black men.


Author(s):  
Matthew Labriola ◽  
Daniel J. George

Black men have a higher prevalence of and mortality rate from prostate cancer compared with White men and have been shown to present with more aggressive and later-stage disease. How prostate cancer treatment affects these racial disparities is still unclear. Several studies have shown that Black men who receive treatment have a more pronounced decrease in prostate cancer–specific death; however, there remains a large disparity in all-cause mortality. This disparity may be in part related to a higher risk of death resulting from comorbidities, given the higher rates of cardiovascular disease and diabetes in Black men, both of which are complicated by the use of androgen-deprivation therapy. To further understand these disparities, it is important that we analyze the racial differences in adverse event rates and severity. Increasing the percentage of Black men in clinical trials will improve the understanding of the biologic drivers of racial disparities in prostate cancer. To evaluate the potential differences in adverse event reporting and demonstrate the feasibility of enrolling equal numbers of Black and White men in trials, we performed a prospective, multicenter study of abiraterone plus prednisone with androgen-deprivation therapy in men with metastatic castration-resistant prostate cancer, stratified by race. Racial differences in prostate-specific antigen kinetics and toxicity profile were demonstrated. Higher rates and severity of adverse events related to adrenal hormone suppression, including hypertension, hypokalemia, and hypomagnesemia, were seen in the Black cohort, not previously reported. Increased enrollment of Black men in prostate cancer clinical trials is imperative to further understand the impact of race on clinical outcomes and treatment tolerability.


2021 ◽  
Author(s):  
Xiao Li ◽  
Zicheng Xu ◽  
Wenbo Xu ◽  
Feng Qi ◽  
Qing Zou

Abstract Background This study aimed to investigate the misclassification rates of Asian-American patients with low-risk prostate cancer who underwent radical prostatectomy (RP). Methods Patients diagnosed with low-risk PCa treated with RP between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. Then, basic characteristics and pathological outcomes of enrolled patients were retrospectively extracted. We compared the rates of upgrading and/or upstaging between Asian-American patients and White/Black patients. Moreover, temporal trend analyses were performed to explore the changes in upgrading and upstaging rates in each race over time. Finally, logistic regression models were constructed to explore the role of Asian race in upgrading and upstaging and to screen out potential risk factors for predicting upgrading and upstaging in Asian-American patients. Results In patients with low-risk PCa, Asian-Americans had significantly higher rate of upgrading than Whites (51.25% vs. 45.18%, P<0.001), while no statistical difference was found in the comparison of upstaging rate (10.01 vs. 10.01, P=0.536). Moreover, Asian-Americans were more likely to upgrade to diseases with higher ISUP grade than Whites (P=0.010). The rate of upgrading increased significantly over time in White and Black patients, but not in Asian-American patients. Finally, race seemed to be an independent risk factor for predicting upgrading, while the racial differences seemed to be more pronounced between White and Black patients. Conclusion Asian-American patients had a significantly higher rate of upgrading than White patients. Moreover, Asian-American patients were more likely to upgrade to diseases with higher ISUP grade. Further risk assessment before clinical decision for low-risk PCa patients with the help of significant clinical variables is required.


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