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Published in: Cancer Causes & Control 8/2014

01-08-2014 | Original paper

The association between race and prostate cancer risk on initial biopsy in an equal access, multiethnic cohort

Authors: Alexis R. Gaines, Elizabeth L. Turner, Patricia G. Moorman, Stephen J. Freedland, Christopher J. Keto, Megan E. McPhail, Delores J. Grant, Adriana C. Vidal, Cathrine Hoyo

Published in: Cancer Causes & Control | Issue 8/2014

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Abstract

Purpose

Population-based studies have established a link between race and prostate cancer (PC) risk, but whether race predicts PC after adjusting for clinical characteristics is unclear. We investigated the association between race and risk of low- and high-grade PC in men undergoing initial prostate biopsy in an equal access medical center.

Methods

We conducted a retrospective record review of 887 men (48.6 % black, 51.4 % white) from the Durham Veterans Affairs Medical Center who underwent initial prostate biopsy between 2001 and 2009. Multivariable logistic regression analysis of race and biopsy outcome was conducted adjusting for age, body mass index, number of cores taken, prostate-specific antigen (PSA), and digital rectal examination findings. Multinomial logistic regression was used to test the association between black race and PC grade (Gleason <7 vs. ≥7).

Results

Black men were younger at biopsy (61 vs. 65 years, p < 0.001) and had a higher pre-biopsy PSA (6.6 vs. 5.8 ng/ml, p = 0.001). A total of 499 men had PC on biopsy (245 low grade; 254 high grade). In multivariable analyses, black race was significantly predictive of PC overall [odds ratio 1.50, p = 0.006] and high-grade PC [relative risk ratio (RRR) 1.84, p = 0.001], but was not significantly associated with low-grade PC (RRR 1.29, p = 0.139).

Conclusion

In an equal access healthcare facility, black race was associated with greater risk of PC detection on initial biopsy and of high-grade PC after adjusting for clinical characteristics. Additional investigation of mechanisms linking black race and PC risk and PC aggressiveness is needed.
Literature
2.
go back to reference Brawley OW, Knopf K, Thompson I (1998) The epidemiology of prostate cancer part II: the risk factors. Semin Urol Oncol 16(4):193–201PubMed Brawley OW, Knopf K, Thompson I (1998) The epidemiology of prostate cancer part II: the risk factors. Semin Urol Oncol 16(4):193–201PubMed
4.
go back to reference Thomas G, Jacobs KB, Yeager M, Kraft P, Wacholder S, Orr N, Yu K, Chatterjee N, Welch R, Hutchinson A, Crenshaw A, Cancel-Tassin G, Staats BJ, Wang Z, Gonzalez-Bosquet J, Fang J, Deng X, Berndt SI, Calle EE, Feigelson HS, Thun MJ, Rodriguez C, Albanes D, Virtamo J, Weinstein S, Schumacher FR, Giovannucci E, Willett WC, Cussenot O, Valeri A, Andriole GL, Crawford ED, Tucker M, Gerhard DS, Fraumeni JF Jr, Hoover R, Hayes RB, Hunter DJ, Chanock SJ (2008) Multiple loci identified in a genome-wide association study of prostate cancer. Nat Genet 40(3):310–315. doi:10.1038/ng.91 PubMedCrossRef Thomas G, Jacobs KB, Yeager M, Kraft P, Wacholder S, Orr N, Yu K, Chatterjee N, Welch R, Hutchinson A, Crenshaw A, Cancel-Tassin G, Staats BJ, Wang Z, Gonzalez-Bosquet J, Fang J, Deng X, Berndt SI, Calle EE, Feigelson HS, Thun MJ, Rodriguez C, Albanes D, Virtamo J, Weinstein S, Schumacher FR, Giovannucci E, Willett WC, Cussenot O, Valeri A, Andriole GL, Crawford ED, Tucker M, Gerhard DS, Fraumeni JF Jr, Hoover R, Hayes RB, Hunter DJ, Chanock SJ (2008) Multiple loci identified in a genome-wide association study of prostate cancer. Nat Genet 40(3):310–315. doi:10.​1038/​ng.​91 PubMedCrossRef
5.
go back to reference Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Dorey FJ, Walsh PC, Partin AW (2005) Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA 294(4):433–439PubMedCrossRef Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Dorey FJ, Walsh PC, Partin AW (2005) Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA 294(4):433–439PubMedCrossRef
6.
go back to reference Johnstone PA, Kane CJ, Sun L, Wu H, Moul JW, McLeod DG, Martin DD, Kusuda L, Lance R, Douglas R, Donahue T, Beat MG, Foley J, Baldwin D, Soderdahl D, Do J, Amling CL (2002) Effect of race on biochemical disease-free outcome in patients with prostate cancer treated with definitive radiation therapy in an equal-access health care system: radiation oncology report of the department of defense center for prostate disease research. Radiology 225(2):420–426PubMedCrossRef Johnstone PA, Kane CJ, Sun L, Wu H, Moul JW, McLeod DG, Martin DD, Kusuda L, Lance R, Douglas R, Donahue T, Beat MG, Foley J, Baldwin D, Soderdahl D, Do J, Amling CL (2002) Effect of race on biochemical disease-free outcome in patients with prostate cancer treated with definitive radiation therapy in an equal-access health care system: radiation oncology report of the department of defense center for prostate disease research. Radiology 225(2):420–426PubMedCrossRef
7.
go back to reference Fowler JE Jr, Terrell F (1996) Survival in blacks and whites after treatment for localized prostate cancer. J Urol 156(1):133–136PubMedCrossRef Fowler JE Jr, Terrell F (1996) Survival in blacks and whites after treatment for localized prostate cancer. J Urol 156(1):133–136PubMedCrossRef
8.
go back to reference Roach M III, Lu J, Pilepich MV, Asbell SO, Mohiuddin M, Grignon D (2003) Race and survival of men treated for prostate cancer on radiation therapy oncology group phase III randomized trials. J Urol 169(1):245–250PubMedCrossRef Roach M III, Lu J, Pilepich MV, Asbell SO, Mohiuddin M, Grignon D (2003) Race and survival of men treated for prostate cancer on radiation therapy oncology group phase III randomized trials. J Urol 169(1):245–250PubMedCrossRef
9.
go back to reference Powell IJ, Schwartz K, Hussain M (1995) Removal of the financial barrier to health care: does it impact on prostate cancer at presentation and survival? A comparative study between black and white men in a Veterans Affairs system. Urology 46(6):825–830. doi:10.1016/S0090-4295(99)80352-5 PubMedCrossRef Powell IJ, Schwartz K, Hussain M (1995) Removal of the financial barrier to health care: does it impact on prostate cancer at presentation and survival? A comparative study between black and white men in a Veterans Affairs system. Urology 46(6):825–830. doi:10.​1016/​S0090-4295(99)80352-5 PubMedCrossRef
10.
go back to reference Hamilton RJ, Aronson WJ, Presti JC Jr, Terris MK, Kane CJ, Amling CL, Freedland SJ (2007) Race, biochemical disease recurrence, and prostate-specific antigen doubling time after radical prostatectomy: results from the SEARCH database. Cancer 110(10):2202–2209 Hamilton RJ, Aronson WJ, Presti JC Jr, Terris MK, Kane CJ, Amling CL, Freedland SJ (2007) Race, biochemical disease recurrence, and prostate-specific antigen doubling time after radical prostatectomy: results from the SEARCH database. Cancer 110(10):2202–2209
12.
go back to reference Kubricht WS, Kattan MW, Sartor O, Eastham JA (1999) Race is not independently associated with a positive prostate biopsy in men suspected of having prostate cancer. Urology 53(3):553–556PubMedCrossRef Kubricht WS, Kattan MW, Sartor O, Eastham JA (1999) Race is not independently associated with a positive prostate biopsy in men suspected of having prostate cancer. Urology 53(3):553–556PubMedCrossRef
13.
go back to reference Tsivian M, Banez LL, Keto CJ, Abern MR, Qi P, Gerber L, Moul JW, Polascik TJ (2012) African-American men with low-grade prostate cancer have higher tumor burdens: results from the Duke Prostate Center. Prostate Cancer Prostatic Dis. doi:10.1038/pcan.2012.39 Tsivian M, Banez LL, Keto CJ, Abern MR, Qi P, Gerber L, Moul JW, Polascik TJ (2012) African-American men with low-grade prostate cancer have higher tumor burdens: results from the Duke Prostate Center. Prostate Cancer Prostatic Dis. doi:10.​1038/​pcan.​2012.​39
14.
go back to reference Polednak AP (2002) Black-white differences in tumor grade (aggressiveness) at diagnosis of prostate cancer, 1992–1998. Ethn Dis 12(4):536–540PubMed Polednak AP (2002) Black-white differences in tumor grade (aggressiveness) at diagnosis of prostate cancer, 1992–1998. Ethn Dis 12(4):536–540PubMed
15.
go back to reference US Department of Veterans Affairs (2013) About the Durham Veterans Affairs Medical Center. US Department of Veterans Affairs, Washington, DC US Department of Veterans Affairs (2013) About the Durham Veterans Affairs Medical Center. US Department of Veterans Affairs, Washington, DC
16.
go back to reference US Department of Veterans Affairs (2012) Health benefits: veteran eligibility. US Department of Veterans Affairs, Washington, DC US Department of Veterans Affairs (2012) Health benefits: veteran eligibility. US Department of Veterans Affairs, Washington, DC
17.
go back to reference US Census Bureau (2011) American Community Survey, public use microdata sample (PUMS). US Department of Commerce, Washington, DC US Census Bureau (2011) American Community Survey, public use microdata sample (PUMS). US Department of Commerce, Washington, DC
18.
go back to reference Department of Defense (2011) Population representation in the military services fiscal year 2011 report. Washington, DC Department of Defense (2011) Population representation in the military services fiscal year 2011 report. Washington, DC
19.
go back to reference Zullig LL, Jackson GL, Dorn RA, Provenzale DT, McNeil R, Thomas CM, Kelley MJ (2012) Cancer incidence among patients of the U.S. Veterans Affairs Health Care System. Mil Med 177(6):693–701PubMedCentralPubMedCrossRef Zullig LL, Jackson GL, Dorn RA, Provenzale DT, McNeil R, Thomas CM, Kelley MJ (2012) Cancer incidence among patients of the U.S. Veterans Affairs Health Care System. Mil Med 177(6):693–701PubMedCentralPubMedCrossRef
20.
go back to reference Agha Z, Lofgren RP, VanRuiswyk JV, Layde PM (2000) Are patients at Veterans Affairs medical centers sicker? A comparative analysis of health status and medical resource use. Arch Intern Med 160(21):3252–3257PubMedCrossRef Agha Z, Lofgren RP, VanRuiswyk JV, Layde PM (2000) Are patients at Veterans Affairs medical centers sicker? A comparative analysis of health status and medical resource use. Arch Intern Med 160(21):3252–3257PubMedCrossRef
21.
go back to reference Moreira DM, Anderson T, Gerber L, Thomas JA, Banez LL, McKeever MG, Hoyo C, Grant D, Jayachandran J, Freedland SJ (2011) The association of diabetes mellitus and high-grade prostate cancer in a multiethnic biopsy series. Cancer Causes Control 22(7):977–983. doi:10.1007/s10552-011-9770-3 PubMedCrossRef Moreira DM, Anderson T, Gerber L, Thomas JA, Banez LL, McKeever MG, Hoyo C, Grant D, Jayachandran J, Freedland SJ (2011) The association of diabetes mellitus and high-grade prostate cancer in a multiethnic biopsy series. Cancer Causes Control 22(7):977–983. doi:10.​1007/​s10552-011-9770-3 PubMedCrossRef
23.
go back to reference Howlader NNA, Krapcho M et al (2013) SEER cancer statistics review, 1975–2010. National Cancer Institute, Bethesda Howlader NNA, Krapcho M et al (2013) SEER cancer statistics review, 1975–2010. National Cancer Institute, Bethesda
24.
go back to reference Odedina FT, Akinremi TO, Chinegwundoh F, Roberts R, Yu D, Reams RR, Freedman ML, Rivers B, Green BL, Kumar N (2009) Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa. Infect Agents cancer 4(Suppl. 1):S2. doi:10.1186/1750-9378-4-S1-S2 PubMedCentralPubMedCrossRef Odedina FT, Akinremi TO, Chinegwundoh F, Roberts R, Yu D, Reams RR, Freedman ML, Rivers B, Green BL, Kumar N (2009) Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa. Infect Agents cancer 4(Suppl. 1):S2. doi:10.​1186/​1750-9378-4-S1-S2 PubMedCentralPubMedCrossRef
26.
go back to reference Thompson IM, Ankerst DP, Chi C, Goodman PJ, Tangen CM, Lucia MS, Feng Z, Parnes HL, Coltman CA Jr (2006) Assessing prostate cancer risk: results from the prostate cancer prevention trial. J Natl Cancer Inst 98(8):529–534. doi:10.1093/jnci/djj131 PubMedCrossRef Thompson IM, Ankerst DP, Chi C, Goodman PJ, Tangen CM, Lucia MS, Feng Z, Parnes HL, Coltman CA Jr (2006) Assessing prostate cancer risk: results from the prostate cancer prevention trial. J Natl Cancer Inst 98(8):529–534. doi:10.​1093/​jnci/​djj131 PubMedCrossRef
28.
go back to reference Carver BS, Bozeman CB, Simoneaux WJ, Venable DD, Kattan MW, Eastham JA (2004) Race is not a predictor of prostate cancer detection on repeat prostate biopsy. J Urol 172(5 Pt 1):1853–1855PubMedCrossRef Carver BS, Bozeman CB, Simoneaux WJ, Venable DD, Kattan MW, Eastham JA (2004) Race is not a predictor of prostate cancer detection on repeat prostate biopsy. J Urol 172(5 Pt 1):1853–1855PubMedCrossRef
29.
go back to reference Bennett CL, Ferreira MR, Davis TC, Kaplan J, Weinberger M, Kuzel T, Seday MA, Sartor O (1998) Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer. J Clin Oncol 16(9):3101–3104PubMed Bennett CL, Ferreira MR, Davis TC, Kaplan J, Weinberger M, Kuzel T, Seday MA, Sartor O (1998) Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer. J Clin Oncol 16(9):3101–3104PubMed
31.
go back to reference Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL, Holmberg L, Kantoff P, Konety BR, Murad MH, Penson DF, Zietman AL (2013) Early detection of prostate cancer: AUA guideline. J Urol 190(2):419–426. doi: 10.1016/j.juro.2013.04.119 Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL, Holmberg L, Kantoff P, Konety BR, Murad MH, Penson DF, Zietman AL (2013) Early detection of prostate cancer: AUA guideline. J Urol 190(2):419–426. doi: 10.​1016/​j.​juro.​2013.​04.​119
32.
go back to reference Carpenter WR, Beskow LM, Blocker DE, Forlenza MJ, Kim AE, Pevzner ES, Rose JM, Tran AN, Webber KH, Knight K, O’Malley MS (2008) Towards a more comprehensive understanding of cancer burden in North Carolina: priorities for intervention. N C Med J 69(4):275–282PubMedCentralPubMed Carpenter WR, Beskow LM, Blocker DE, Forlenza MJ, Kim AE, Pevzner ES, Rose JM, Tran AN, Webber KH, Knight K, O’Malley MS (2008) Towards a more comprehensive understanding of cancer burden in North Carolina: priorities for intervention. N C Med J 69(4):275–282PubMedCentralPubMed
33.
go back to reference Porterfield D, Knight K (2006) Running the numbers: a periodic feature to inform North Carolina healthcare professionals about current topics in health statistics. N C Med J 67(3):235–236 Porterfield D, Knight K (2006) Running the numbers: a periodic feature to inform North Carolina healthcare professionals about current topics in health statistics. N C Med J 67(3):235–236
34.
go back to reference Nixon RG, Meyer GE, Brawer MK (1999) Differences in prostate size between patients from university and Veterans Affairs Medical Center populations. Prostate 38(2):144–150PubMedCrossRef Nixon RG, Meyer GE, Brawer MK (1999) Differences in prostate size between patients from university and Veterans Affairs Medical Center populations. Prostate 38(2):144–150PubMedCrossRef
35.
go back to reference Warren JL, Klabunde CN, Schrag D, Bach PB, Riley GF (2002) Overview of the SEER-Medicare data: content, research applications, and generalizability to the United States elderly population. Med Care 40(8 Suppl.):IV-3–IV-18. doi:10.1097/01.MLR.0000020942.47004.03 Warren JL, Klabunde CN, Schrag D, Bach PB, Riley GF (2002) Overview of the SEER-Medicare data: content, research applications, and generalizability to the United States elderly population. Med Care 40(8 Suppl.):IV-3–IV-18. doi:10.​1097/​01.​MLR.​0000020942.​47004.​03
36.
go back to reference Boyko EJ, Koepsell TD, Gaziano JM, Horner RD, Feussner JR (2000) US Department of Veterans Affairs medical care system as a resource to epidemiologists. Am J Epidemiol 151(3):307–314PubMedCrossRef Boyko EJ, Koepsell TD, Gaziano JM, Horner RD, Feussner JR (2000) US Department of Veterans Affairs medical care system as a resource to epidemiologists. Am J Epidemiol 151(3):307–314PubMedCrossRef
37.
go back to reference Du XL, Fang S, Coker AL, Sanderson M, Aragaki C, Cormier JN, Xing Y, Gor BJ, Chan W (2006) Racial disparity and socioeconomic status in association with survival in older men with local/regional stage prostate carcinoma: findings from a large community-based cohort. Cancer 106(6):1276–1285. doi:10.1002/cncr.21732 PubMedCrossRef Du XL, Fang S, Coker AL, Sanderson M, Aragaki C, Cormier JN, Xing Y, Gor BJ, Chan W (2006) Racial disparity and socioeconomic status in association with survival in older men with local/regional stage prostate carcinoma: findings from a large community-based cohort. Cancer 106(6):1276–1285. doi:10.​1002/​cncr.​21732 PubMedCrossRef
39.
Metadata
Title
The association between race and prostate cancer risk on initial biopsy in an equal access, multiethnic cohort
Authors
Alexis R. Gaines
Elizabeth L. Turner
Patricia G. Moorman
Stephen J. Freedland
Christopher J. Keto
Megan E. McPhail
Delores J. Grant
Adriana C. Vidal
Cathrine Hoyo
Publication date
01-08-2014
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 8/2014
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-014-0402-6

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