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Racial variation in prostate cancer incidence and in hormonal system markers among male health professionals.

Abstract

BACKGROUND

Racial variation in prostate cancer incidence in the United States is pronounced, with African-American men having the highest rates. Whether differences in the distribution of known or suspected risk factors among racial groups explain this variation is unknown.

METHODS

We evaluated prospectively the relation between prostate cancer and race among 45 410 U.S. male health professionals aged 40--75 years in 1986. We used multivariable, pooled logistic regression to adjust the rate ratio (RR) for potential dietary and lifestyle risk factors. We also measured circulating levels of steroid hormones, sex hormone-binding globulin, and vitamin D metabolites and length of the androgen receptor gene CAG repeat in a sample of African-American (n = 43), Asian (n = 52), and white (n = 55) participants and assessed variation by race in these possible prostate epithelial cell growth mediators by use of analysis of variance. Statistical tests were two-sided.

RESULTS

The age-adjusted RR for prostate cancer was 1.73 (95% confidence interval [CI] = 1.23--2.45) for African-American men compared with white men. After multivariate adjustment, the RR increased to 1.81 (95% CI = 1.27--2.58). The rate of prostate cancer did not differ between Asians and whites. Steroid hormone and 1,25-dihydroxyvitamin D levels did not vary appreciably by race. However, the mean number of androgen receptor gene CAG repeats was lower among African-Americans (mean +/- standard deviation = 20.1 +/- 3.5) than among whites (22.1 +/- 3.1; P =.007) and Asians (22.1 +/- 3.9; P =.009).

CONCLUSIONS

Our results confirm the elevated incidence of prostate cancer among African Americans and show that it is not explained by differences in the distribution of possible dietary and lifestyle risk factors in this cohort. Racial variation in length of the androgen receptor gene CAG repeat may explain a small part of the excess risk of prostate cancer among African-American men in this cohort.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. eplatz@jhsph.edu

    , , ,

    Source

    Journal of the National Cancer Institute 92:24 2000 Dec 20 pg 2009-17

    MeSH

    Adult
    African Americans
    Aged
    Asian Americans
    Biomarkers, Tumor
    European Continental Ancestry Group
    Feeding Behavior
    Follow-Up Studies
    Health Personnel
    Humans
    Incidence
    Life Style
    Logistic Models
    Male
    Middle Aged
    Multivariate Analysis
    Odds Ratio
    Prospective Studies
    Prostatic Neoplasms
    Receptors, Androgen
    Risk
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    11121463

    Citation

    Platz, E A., et al. "Racial Variation in Prostate Cancer Incidence and in Hormonal System Markers Among Male Health Professionals." Journal of the National Cancer Institute, vol. 92, no. 24, 2000, pp. 2009-17.
    Platz EA, Rimm EB, Willett WC, et al. Racial variation in prostate cancer incidence and in hormonal system markers among male health professionals. J Natl Cancer Inst. 2000;92(24):2009-17.
    Platz, E. A., Rimm, E. B., Willett, W. C., Kantoff, P. W., & Giovannucci, E. (2000). Racial variation in prostate cancer incidence and in hormonal system markers among male health professionals. Journal of the National Cancer Institute, 92(24), pp. 2009-17.
    Platz EA, et al. Racial Variation in Prostate Cancer Incidence and in Hormonal System Markers Among Male Health Professionals. J Natl Cancer Inst. 2000 Dec 20;92(24):2009-17. PubMed PMID: 11121463.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Racial variation in prostate cancer incidence and in hormonal system markers among male health professionals. AU - Platz,E A, AU - Rimm,E B, AU - Willett,W C, AU - Kantoff,P W, AU - Giovannucci,E, PY - 2000/12/21/pubmed PY - 2001/5/18/medline PY - 2000/12/21/entrez SP - 2009 EP - 17 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 92 IS - 24 N2 - BACKGROUND: Racial variation in prostate cancer incidence in the United States is pronounced, with African-American men having the highest rates. Whether differences in the distribution of known or suspected risk factors among racial groups explain this variation is unknown. METHODS: We evaluated prospectively the relation between prostate cancer and race among 45 410 U.S. male health professionals aged 40--75 years in 1986. We used multivariable, pooled logistic regression to adjust the rate ratio (RR) for potential dietary and lifestyle risk factors. We also measured circulating levels of steroid hormones, sex hormone-binding globulin, and vitamin D metabolites and length of the androgen receptor gene CAG repeat in a sample of African-American (n = 43), Asian (n = 52), and white (n = 55) participants and assessed variation by race in these possible prostate epithelial cell growth mediators by use of analysis of variance. Statistical tests were two-sided. RESULTS: The age-adjusted RR for prostate cancer was 1.73 (95% confidence interval [CI] = 1.23--2.45) for African-American men compared with white men. After multivariate adjustment, the RR increased to 1.81 (95% CI = 1.27--2.58). The rate of prostate cancer did not differ between Asians and whites. Steroid hormone and 1,25-dihydroxyvitamin D levels did not vary appreciably by race. However, the mean number of androgen receptor gene CAG repeats was lower among African-Americans (mean +/- standard deviation = 20.1 +/- 3.5) than among whites (22.1 +/- 3.1; P =.007) and Asians (22.1 +/- 3.9; P =.009). CONCLUSIONS: Our results confirm the elevated incidence of prostate cancer among African Americans and show that it is not explained by differences in the distribution of possible dietary and lifestyle risk factors in this cohort. Racial variation in length of the androgen receptor gene CAG repeat may explain a small part of the excess risk of prostate cancer among African-American men in this cohort. SN - 0027-8874 UR - https://www.unboundmedicine.com/medline/citation/11121463/full_citation L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11121463.ui DB - PRIME DP - Unbound Medicine ER -