African American (AA) men experience more than twice the prostate cancer mortality as White men yet are under-represented in academic research involving prostate-specific antigen (PSA), a biomarker of prostate cancer aggressiveness. We examined the impact of self-reported tobacco (cigarette pack-years and current tobacco use including e-cigarettes) and current regular marijuana use on serum PSA level based on clinical laboratory testing among 928 AA men interviewed 2013-2018 in Chicago. We defined outcome of elevated PSA ≥ 4.0 ng/mL for logistic regression models and continuous PSA increases for general linear models. All models were adjusted for age, sociodemographic characteristics, healthcare utilization, body mass index, and self-reported health. Among 431 AA men age ≥ 55 years, we observed ∼ 5 times the odds of elevated PSA among those with > 1 pack-years of cigarette smoking vs. never-smokers (odds ratio [OR] = 5.09; 95% confidence interval [CI] = 1.57-16.6) and a quarter the odds of elevated PSA among current marijuana users vs. non-users (OR = 0.27; 95% CI = 0.08-0.96). PSA increased on average 1.20 ng/mL among other current tobacco users vs. non-users. Among older AA men, cigarette smoking history and current tobacco use were positively associated with an increase in PSA levels and current marijuana use were inversely associated with PSA levels. Future work with studies of diverse patient populations with cancer outcomes are needed to assess whether these behavioral characteristics contribute to racial/ ethnic disparities in prostate cancer outcomes. Our study provides novel evidence regarding potential differences in PSA levels among older AA men according to behavioral characteristics.
Preventive medicine reports. 2020 Aug 11*** epublish ***
David J Press, Brandon Pierce, Diane S Lauderdale, Briseis Aschebrook-Kilfoy, Scarlett Lin Gomez, Donald Hedeker, Nathaniel E Wright, Richard J Fantus, Luís Bettencourt, Habibul Ahsan, Scott Eggener
Department of Public Health Sciences, University of Chicago, Chicago, IL, USA., Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA, USA., Medical Scientist Training Program, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA., Department of Surgery, University of Chicago, Chicago, IL, USA., Mansueto Institute for Urban Innovation, University of Chicago, Chicago, IL, USA.