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J Urol. 2014 Sep;192(3):730-5. doi: 10.1016/j.juro.2014.04.017. Epub 2014 Apr 18.

High prevalence of screen detected prostate cancer in West Africans: implications for racial disparity of prostate cancer.

Author information

1
Cancer Prevention Institute of California, Fremont, California; Stanford Cancer Institute, Stanford University, Stanford, California; Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland. Electronic address: ann.hsing@cpic.org.
2
School of Medicine, University of Ghana, Accra, Ghana.
3
James Buchanan Brady Urological Institute, Department of Pathology and Oncology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.
4
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
5
Department of Epidemiology, University of California-Berkeley, Berkeley, California.
6
Cancer Prevention Institute of California, Fremont, California; Stanford Cancer Institute, Stanford University, Stanford, California.
7
School of Medicine, University of California-Los Angeles, Los Angeles, California.
8
University of Texas Health Science Center at San Antonio, San Antonio, Texas.
9
Westat, Rockville, Maryland.
10
International Epidemiology Institute, Rockville, Maryland.

Abstract

PURPOSE:

To our knowledge the reasons for the high rates of prostate cancer in black American men are unknown. Genetic and lifestyle factors have been implicated. Better understanding of prostate cancer rates in West African men would help clarify why black American men have such high rates since the groups share genetic ancestry and yet have different lifestyles and screening practices. To estimate the prostate cancer burden in West African men we performed a population based screening study with biopsy confirmation in Ghana.

MATERIALS AND METHODS:

We randomly selected 1,037 healthy men 50 to 74 years old from Accra, Ghana for prostate cancer screening with prostate specific antigen testing and digital rectal examination. Men with a positive screen result (positive digital rectal examination or prostate specific antigen greater than 2.5 ng/ml) underwent transrectal ultrasound guided biopsies.

RESULTS:

Of the 1,037 men 154 (14.9%) had a positive digital rectal examination and 272 (26.2%) had prostate specific antigen greater than 2.5 ng/ml, including 166 with prostate specific antigen greater than 4.0 ng/ml. A total of 352 men (33.9%) had a positive screen by prostate specific antigen or digital rectal examination and 307 (87%) underwent biopsy. Of these men 73 were confirmed to have prostate cancer, yielding a 7.0% screen detected prostate cancer prevalence (65 patients), including 5.8% with prostate specific antigen greater than 4.0 ng/ml.

CONCLUSIONS:

In this relatively unscreened population in Africa the screen detected prostate cancer prevalence is high, suggesting a possible role of genetics in prostate cancer etiology and the disparity in prostate cancer risk between black and white American men. Further studies are needed to confirm the high prostate cancer burden in African men and the role of genetics in prostate cancer etiology.

KEYWORDS:

Africa; African Americans; mass screening; prostate-specific antigen; prostatic neoplasms

Comment in

PMID:
24747091
PMCID:
PMC4332806
DOI:
10.1016/j.juro.2014.04.017
[Indexed for MEDLINE]
Free PMC Article
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