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

Cancer Causes & Control volume 25, pages 1029–1035 (2014)Cite this article

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.

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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)

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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.

Author information

Affiliations

  1. Global Health Institute, Duke University, Durham, NC, USA

    Alexis R. Gaines & Elizabeth L. Turner

  2. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA

    Elizabeth L. Turner

  3. Department of Obstetrics and Gynecology, Cancer Detection, Prevention and Control Program, Duke Cancer Institute, Duke University, Durham, NC, 27710, USA

    Patricia G. Moorman, Adriana C. Vidal & Cathrine Hoyo

  4. Duke Cancer Institute, Duke University, Durham, NC, USA

    Patricia G. Moorman, Stephen J. Freedland & Cathrine Hoyo

  5. Duke University School of Nursing, Durham, NC, USA

    Cathrine Hoyo

  6. Department of Urologic Surgery, Akron General Medical Center, Akron, OH, USA

    Christopher J. Keto

  7. Urology Section, Veterans Affairs Medical Center, Durham, NC, USA

    Stephen J. Freedland, Megan E. McPhail & Adriana C. Vidal

  8. Division of Urology, Department of Surgery, Duke Prostate Center, Duke University School of Medicine, Durham, NC, USA

    Stephen J. Freedland, Megan E. McPhail & Adriana C. Vidal

  9. Department of Biology and Cancer Research Program, JLC-Biomedical/Biotechnology Research Institute, North Carolina Central University, Durham, NC, USA

    Delores J. Grant

  10. Department of Pathology, Duke University School of Medicine, Durham, NC, USA

    Stephen J. Freedland

Authors
  1. Alexis R. Gaines
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  2. Elizabeth L. Turner
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  9. Cathrine Hoyo
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Correspondence to Cathrine Hoyo.

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Gaines, A.R., Turner, E.L., Moorman, P.G. et al. The association between race and prostate cancer risk on initial biopsy in an equal access, multiethnic cohort. Cancer Causes Control 25, 1029–1035 (2014). https://doi.org/10.1007/s10552-014-0402-6

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  • DOI: https://doi.org/10.1007/s10552-014-0402-6

Keywords

  • Prostate cancer
  • Risk
  • Initial biopsy
  • Race
  • Equal access