IMPORTANCE - African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men.
OBJECTIVE - To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race.
DESIGN, SETTING AND PARTICIPANTS - Prospective study of 3398 African American and 22 673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001-2011) with present analyses completed in 2014.
MAIN OUTCOMES AND MEASURES - Total, low-grade (Gleason score <7), and high-grade (Gleason score ≥7) prostate cancer incidence.
RESULTS - With a median (interquartile range) follow-up of 5.6 (1.8) years, there were 270, 148, and 88 cases of total, low-, and high-grade prostate cancers among African American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI,
CONCLUSION AND RELEVANCE - Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men.
JAMA Oncol. 2015 Jun 1;1(3):342-9. doi: 10.1001/jamaoncol.2015.0513.
Barrington WE1, Schenk JM2, Etzioni R3, Arnold KB4, Neuhouser ML2, Thompson IM Jr5, Lucia MS6, Kristal AR3.
1 Department of Psychosocial and Community Health, University of Washington, Seattle2Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle3Department of Epidemiology, University of Washington, Seattle.
2 Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle.
3 Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle3Department of Epidemiology, University of Washington, Seattle.
4 SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle.
5 Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio.
6 University of Colorado Denver School of Medicine, Aurora, Colorado.