PURPOSE: Reasons for the high rates of prostate cancer in African Americans are unknown; both genetic and lifestyle factors have been implicated.
A better understanding of prostate cancer rates in West Africans would help clarify why African Americans have such high rates, since African Americans share genetic ancestry with West Africans yet have very different lifestyles and screening practices. To estimate prostate cancer burden in West Africans, we conducted a population-based screening study with biopsy confirmation in Ghana.
MATERIALS AND METHODS: We randomly selected 1,037 healthy men aged 50-74 from Accra, Ghana for prostate cancer screening with prostate specific antigen (PSA) testing and digital rectal examination (DRE). Men who had a positive screen (DRE+ or PSA >2.5 ng/ml) underwent transrectal ultrasound (TRUS)-guided biopsies.
RESULTS: Of the 1,037 men, 154 (14.9%) had a positive DRE and 272 (26.2%) had a PSA >2.5 ng/ml (166 had a PSA >4.0 ng/ml). In total, 352 (33.9%) men had a positive screen by PSA or DRE, and 307 (87%) had a biopsy. Of these, 73 were confirmed to have prostate cancer, yielding a 7.0% screen-detected prevalence of prostate cancer (65 cases, 5.8% with a PSA >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 both prostate cancer etiology and the disparity in prostate cancer risk between African Americans and Caucasian Americans. Further studies are needed to confirm the high prostate cancer burden in Africans and the role of genetics in prostate cancer etiology.
Written by:
Hsing AW, Yeboah E, Biritwum R, Tettey Y, De Marzo AM, Adjei A, Netto G, Yu K, Li Y, Chokkalingam AP, Chu LW, Chia D, Partin A, Thompson IM, Quraishi SM, Niwa S, Tarone R, Hoover RN. Are you the author?
Cancer Prevention Institute of California; Stanford Cancer Institute; Department of Health Research and Policy, School of Medicine, Stanford University; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; School of Medicine, University of Ghana; James Buchanan Brady Urological Institute, Department of Pathology and Oncology, the Johns Hopkins School of Medicine, Johns Hopkins University; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; Department of Epidemiology, University of California at Berkeley; Cancer Prevention Institute of California; Stanford Cancer Institute; School of Medicine, University of California at Los Angeles; University of Texas Health Science Center at San Antonio; Westat, Rockville, MD; International Epidemiology Institute.
Reference: J Urol. 2014 Apr 17. pii: S0022-5347(14)03345-X.
doi: 10.1016/j.juro.2014.04.017
PubMed Abstract
PMID: 24747091
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