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Cancer Causes & Control

, Volume 25, Issue 8, pp 1029–1035 | Cite as

The association between race and prostate cancer risk on initial biopsy in an equal access, multiethnic cohort

  • Alexis R. Gaines
  • Elizabeth L. Turner
  • Patricia G. Moorman
  • Stephen J. Freedland
  • Christopher J. Keto
  • Megan E. McPhail
  • Delores J. Grant
  • Adriana C. Vidal
  • Cathrine Hoyo
Original paper

Abstract

Purpose

Population-based studies have established a link between race and prostate cancer (PC) risk, but whether race predicts PC after adjusting for clinical characteristics is unclear. We investigated the association between race and risk of low- and high-grade PC in men undergoing initial prostate biopsy in an equal access medical center.

Methods

We conducted a retrospective record review of 887 men (48.6 % black, 51.4 % white) from the Durham Veterans Affairs Medical Center who underwent initial prostate biopsy between 2001 and 2009. Multivariable logistic regression analysis of race and biopsy outcome was conducted adjusting for age, body mass index, number of cores taken, prostate-specific antigen (PSA), and digital rectal examination findings. Multinomial logistic regression was used to test the association between black race and PC grade (Gleason <7 vs. ≥7).

Results

Black men were younger at biopsy (61 vs. 65 years, p < 0.001) and had a higher pre-biopsy PSA (6.6 vs. 5.8 ng/ml, p = 0.001). A total of 499 men had PC on biopsy (245 low grade; 254 high grade). In multivariable analyses, black race was significantly predictive of PC overall [odds ratio 1.50, p = 0.006] and high-grade PC [relative risk ratio (RRR) 1.84, p = 0.001], but was not significantly associated with low-grade PC (RRR 1.29, p = 0.139).

Conclusion

In an equal access healthcare facility, black race was associated with greater risk of PC detection on initial biopsy and of high-grade PC after adjusting for clinical characteristics. Additional investigation of mechanisms linking black race and PC risk and PC aggressiveness is needed.

Keywords

Prostate cancer Risk Initial biopsy Race Equal access 

Abbreviations

BMI

Body mass index (kg/m2)

CI

Confidence interval

DRE

Digital rectal exam

DVAMC

Durham Veterans Affairs Medical Center

IQR

Interquartile range

OR

Odds ratio

RRR

Relative risk ratio

P

p value

PC

prostate cancer

PSA

prostate specific antigen (ng/mL)

Notes

Acknowledgments

We would like to acknowledge L. Gerber for her assistance in maintaining the database used for this study.

Conflict of interest

The authors have no actual or potential conflict of interest in relation to this manuscript.

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Alexis R. Gaines
    • 1
  • Elizabeth L. Turner
    • 1
    • 2
  • Patricia G. Moorman
    • 3
    • 4
  • Stephen J. Freedland
    • 4
    • 7
    • 8
    • 10
  • Christopher J. Keto
    • 6
  • Megan E. McPhail
    • 7
    • 8
  • Delores J. Grant
    • 9
  • Adriana C. Vidal
    • 3
    • 7
    • 8
  • Cathrine Hoyo
    • 3
    • 4
    • 5
  1. 1.Global Health InstituteDuke UniversityDurhamUSA
  2. 2.Department of Biostatistics and BioinformaticsDuke UniversityDurhamUSA
  3. 3.Department of Obstetrics and Gynecology, Cancer Detection, Prevention and Control Program, Duke Cancer InstituteDuke UniversityDurhamUSA
  4. 4.Duke Cancer InstituteDuke UniversityDurhamUSA
  5. 5.Duke University School of NursingDurhamUSA
  6. 6.Department of Urologic SurgeryAkron General Medical CenterAkronUSA
  7. 7.Urology SectionVeterans Affairs Medical CenterDurhamUSA
  8. 8.Division of Urology, Department of Surgery, Duke Prostate CenterDuke University School of MedicineDurhamUSA
  9. 9.Department of Biology and Cancer Research Program, JLC-Biomedical/Biotechnology Research InstituteNorth Carolina Central UniversityDurhamUSA
  10. 10.Department of PathologyDuke University School of MedicineDurhamUSA

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