Racial and Ethnic Trends in Prostate Cancer Incidence and Mortality in Philadelphia, PA: an Observational Study
To learn more about local prostate cancer (PCa) disparities, we conducted descriptive analyses of the role of race and age in PCa using the Pennsylvania Cancer Registry data for Philadelphia (2005–2014).
We focused on the most prevalent race/ethnic groups: white (33%), black (44%), and Hispanic (9%). Outcomes included PCa rates, tumor stage, and tumor grade. Percent change was used to describe changes in age-adjusted incidence and mortality rates. Frequency tables and logistic regression models were used to describe trends in proportions of advanced PCa by race and time. Race-by-time interaction terms were retained in the models if statistically significant.
PCa incidence was highest for black men over time. Incidence rates declined over time for all race groups (− 28% for white men to − 38% for Hispanic men). PCa mortality rates declined in a less universal manner (− 5% for blacks to − 32% for whites). Each year, odds increased across all race groups for advanced tumor stage (4% each year among white and Hispanic men and 9% each year among black men) and for advanced tumor grade (4% each year among white and black men and 23% each year among Hispanic men). Among younger men, black men experienced significantly increased odds of advanced tumor stage each year (8%) and Hispanics experienced significantly increased odds of advanced tumor grade each year (30%).
Black men remain at highest PCa risk relative to other racial/ethnic groups in Philadelphia. Younger black and Hispanic men are at particular risk for advanced PCa at diagnosis.
KeywordsProstate cancer trends Philadelphia Race/ethnicity
United States Preventive Services Task Force
Enterprise Data Dissemination Informatics Exchange
Prostate specific antigen
Risk-adjusted incidence rates
CZJ acquired data; was responsible for the study concept/design, analysis, and interpretation; and drafted the manuscript. SK assisted with data analysis and interpretation and revised the manuscript. RM revised the manuscript. TR was responsible for the data analysis and revised the manuscript. AL revised the manuscript. KG was responsible for the study concept and revised the manuscript.
This study was funded by the Department of Defense (DOD W81XWH-15-1-0693). However, the DOD did not play a role in the study design, analysis, interpretation of results, or writing of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict interests.
Ethics Approval and Consent to Participate
This observational study based upon Pennsylvania Cancer Registry data was approved by the Institutional Review Board (IRB) at Thomas Jefferson University (Philadelphia, PA). The IRB reference number is 15G.337. Informed consent was waived by the review board.
- 1.Howlader N, Noone A, Krapcho M, Garshell J, Miller D, Altekruse S, et al. SEER cancer statistics review, 1975–2011. Besthesda: National Cancer Institute; 2014.Google Scholar
- 2.SEER. SEER cancer statistics factsheets: prostate cancer. Bethesda: National Cancer Institute; 2016.Google Scholar
- 3.Rebbeck TR, Haas GP. Temporal trends and racial disparities in global prostate cancer prevalence. Can J Urol. 2014;21:7496–506.Google Scholar
- 9.PA_Prostate_Cancer_Task_Force (2017) Prostate cancer recommendations for improving the health of Pennsylvania men.Google Scholar
- 10.The_PEW_Cheritable_Trusts (2011) A city transformed—the racial and ethnic changes in Philadelphia over the last 20 years.Google Scholar
- 11.PA_Department_of_Health (2017) Enterprise data dissemination informatics exchange.Google Scholar
- 12.Lee DJ, Mallin K, Graves AJ, Chang SS, Penson DF, Resnick MJ, et al. Recent changes in prostate cancer screening practices and epidemiology. In: J Urol, vol. 198; 2017. p. 1230–40.Google Scholar
- 13.Houston KA, King J, Li J, Jemal A (2018) Trends in prostate cancer incidence rates and prevalence of prostate-specific antigen screening by socioeconomic status and regions in the US, 2004–2013. J Urol. 199:676–682.Google Scholar
- 19.Loeb S. Guideline of guidelines: prostate cancer screening. BJU Int. 2014;114:323–5.Google Scholar
- 30.Public Health Management Corporation (2015) Community Health Database. http://www.phmc.org/site/index.php. Accessed 3 Jan 2017.
- 39.Gonsalves L, Cartmel B, Mueller L. The burden of cancer in Connecticut. Conn Med. 2012;76:335–51.Google Scholar