Journal of Immigrant and Minority Health

, Volume 17, Issue 3, pp 625–631

Prostate Cancer Prognostic Factors Among Asian Patients Born in the US Compared to Those Born Abroad

  • Junjun Xu
  • Michael Goodman
  • Ahemdin Jemal
  • Stacey A. Fedewa
Original Paper

Abstract

US surveillance data indicate that incidence of prostate cancer differs by place of birth among Asian men. However, it is less clear if the prognostic factors for prostate cancer also differ by place of birth. The study included 7,824 Asian prostate cancer patients diagnosed between 2004 and 2009 and reported to the Surveillance Epidemiology and End Results (SEER) program. Logistic regression models were used to evaluate the relation of place of birth (foreign born vs. US born) to three outcomes: prostate specific antigen (PSA) level, Gleason score, and T classification, adjusting for age, marital status, Rural–Urban Continuum Code, and SEER registry. All outcome variables were binary using different cutoffs: ≥4, ≥10 and ≥20 ng/ml for PSA; ≥7 and ≥8 for Gleason score; and ≥T2 and ≥T3 for T classification. Elevated PSA was more common among foreign born Asian men regardless of the cut point used. In the analysis comparing foreign born versus US born patients by ethnic group, the association with PSA was most pronounced at cut point of ≥20 ng/ml for Chinese men (OR 1.68, 95 % CI 1.02–2.75), and at cut point of ≥4 ng/ml for Japanese men (OR 2.73, 95 % CI 1.20–6.21). A statistically significant association with Gleason score was only found for Japanese men and only for the cutoff ≥7 (OR 1.71, 95 % CI 1.12–2.61). There was no difference in clinical T classification between foreign-born and US-born Asian men. Inclusion of cases with missing place of birth or restriction of data to those who underwent radical prostatectomy did not substantially change the results. The data suggest that foreign-born Asian prostate cancer patients may have moderately elevated PSA levels at diagnosis compared with their US born counterparts. For the other prognostic markers, the associations were less consistent and did not form a discernible pattern.

Keywords

Prostate cancer Asian Americans Immigrants Gleason score PSA 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Junjun Xu
    • 1
  • Michael Goodman
    • 1
  • Ahemdin Jemal
    • 2
  • Stacey A. Fedewa
    • 1
  1. 1.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.Surveillance and Health Services ResearchAmerican Cancer SocietyAtlantaUSA

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