Racial and Ethnic Differences in Advanced-Stage Prostate Cancer: the Prostate Cancer Outcomes Study.
Hoffman, Richard M. 1; Gilliland, Frank D. 3; Eley, J. William 4; Harlan, Linda C. 5; Stephenson, Robert A. 6; Stanford, Janet L. 7; Albertson, Peter C. 8; Hamilton, Ann S. 3; Hunt, W. Curtis 2; Potosky, Arnold L. 5
[Report]
Journal of the National Cancer Institute.
93(5):388-395, March 7, 2001.
(Format: HTML, PDF)
Background: African-Americans have twice the risk of non-Hispanic whites for presenting with advanced-stage prostate cancer. To investigate the reasons for this difference, we evaluated the association between race/ethnicity and advanced-stage prostate cancer, adjusting for demographic, socioeconomic, clinical, and pathologic factors.
Methods: A population-based cohort of 3173 men diagnosed with prostate cancer between October 1, 1994, and October 31, 1995, was analyzed. Medical record abstracts and self-administered survey questionnaires were used to obain information regarding race/ethnicity, age, marital status, insurance status, educational level, household income, employment status, comorbidity, urinary function, prostate-specific antigen level, tumor grade, and clinical stage. The odds ratio (OR) for advanced-stage prostate cancer was estimated with weighted logistic regression analysis. All P values were two-sided.
Results: Clinically advanced-stage prostate cancers were detected more frequently in African-Americans (12.3%) and Hispanics (10.5%) than in non-Hispanic whites (6.3%). Socioeconomic, clinical, and pathologic factors each accounted for about 15% of the increased relative risk. After adjusting for all covariates, the risk remained statistically significantly increased for African-Americans (OR=2.26; 95% confidence interval [CI]=1.43 to 3.58) but not for Hispanics (OR=1.23; 95% CI=0.73 to 2.08).
Conclusion: Traditional socioeconomic, clinical, and pathologic factors accounted for the increased relative risk for presenting with advanced-stage prostate cancer in Hispanic but not in African-American men.
(C) Copyright Oxford University Press 2001.