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Differences in the prevalence of modifiable risk and protective factors for prostate cancer by race and ethnicity in the National Health and Nutrition Examination Survey

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Abstract

Purpose

Prostate cancer burden is disproportionate by race. Black men have the highest incidence and mortality rates. Rates for Hispanic men are significantly lower than for non-Hispanic Whites. Whether differences in prevalences of modifiable risk and protective factors for prostate cancer may explain these racial/ethnic differences remains unclear.

Methods

We used data from the National Health and Nutrition Examination Surveys (NHANES), which are cross-sectional and nationally representative. We selected factors known or suspected to be associated with prostate cancer and calculated risk scores combining key factors. Age-adjusted means and proportions were calculated for each factor and risk score by race/ethnicity. We estimated odds ratios (OR) using polytomous logistic regression.

Results

Prevalences of most factors are statistically significantly differed by race/ethnicity. In NHANES III, the prevalence of high risk score (i.e., > 25th percentile for all participants) was lower for all groups (non-Hispanic Black = 59.4%, non-US-born Mexican American = 51.4%, US-born Mexican American = 61.4%) vs. non-Hispanic White men (76.4%). Similar findings were observed for the fatal weighted risk score and for continuous NHANES.

Conclusions

Our findings from this nationally representative study suggest that a combination of multiple risk and protective factors may help to explain the lower rates of prostate cancer in Mexican Americans. However, variation in these factors did not explain the higher risk of prostate cancer in non-Hispanic Black men. No one lifestyle change can reduce prostate cancer equally across all racial/ethnic groups, and modifiable factors may not explain the increased risk in black men at all. Secondary prevention strategies may provide the most benefit for black men.

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Funding

Elizabeth Platz is funded, in part, by Grant # P30 CA006973.

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Authors and Affiliations

  1. Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA

    Kali Defever & Alison M. Mondul

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Elizabeth A. Platz

  3. Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA

    Elizabeth A. Platz

  4. Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Elizabeth A. Platz

  5. Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, USA

    David S. Lopez

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  1. Kali Defever
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  2. Elizabeth A. Platz
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  4. Alison M. Mondul
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Correspondence to Alison M. Mondul.

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Defever, K., Platz, E.A., Lopez, D.S. et al. Differences in the prevalence of modifiable risk and protective factors for prostate cancer by race and ethnicity in the National Health and Nutrition Examination Survey. Cancer Causes Control 31, 851–860 (2020). https://doi.org/10.1007/s10552-020-01326-9

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  • DOI: https://doi.org/10.1007/s10552-020-01326-9

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