High prevalence of screen detected prostate cancer in West Africans: Implications for racial disparity of prostate cancer

Ann W. Hsing, Edward Yeboah, Richard Biritwum, Yao Tettey, Angelo M. De Marzo, Andrew Adjei, George J. Netto, Kai Yu, Yan Li, Anand P. Chokkalingam, Lisa W. Chu, David Chia, Alan Partin, Ian M. Thompson, Sabah M. Quraishi, Shelley Niwa, Robert Tarone, Robert N. Hoover

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Purpose To our knowledge the reasons for the high rates of prostate cancer in black American men are unknown. Genetic and lifestyle factors have been implicated. Better understanding of prostate cancer rates in West African men would help clarify why black American men have such high rates since the groups share genetic ancestry and yet have different lifestyles and screening practices. To estimate the prostate cancer burden in West African men we performed a population based screening study with biopsy confirmation in Ghana. Materials and Methods We randomly selected 1,037 healthy men 50 to 74 years old from Accra, Ghana for prostate cancer screening with prostate specific antigen testing and digital rectal examination. Men with a positive screen result (positive digital rectal examination or prostate specific antigen greater than 2.5 ng/ml) underwent transrectal ultrasound guided biopsies. Results Of the 1,037 men 154 (14.9%) had a positive digital rectal examination and 272 (26.2%) had prostate specific antigen greater than 2.5 ng/ml, including 166 with prostate specific antigen greater than 4.0 ng/ml. A total of 352 men (33.9%) had a positive screen by prostate specific antigen or digital rectal examination and 307 (87%) underwent biopsy. Of these men 73 were confirmed to have prostate cancer, yielding a 7.0% screen detected prostate cancer prevalence (65 patients), including 5.8% with prostate specific antigen greater than 4.0 ng/ml. Conclusions In this relatively unscreened population in Africa the screen detected prostate cancer prevalence is high, suggesting a possible role of genetics in prostate cancer etiology and the disparity in prostate cancer risk between black and white American men. Further studies are needed to confirm the high prostate cancer burden in African men and the role of genetics in prostate cancer etiology.

Original languageEnglish (US)
Pages (from-to)730-736
Number of pages7
JournalJournal of Urology
Volume192
Issue number3
DOIs
StatePublished - Sep 2014

Keywords

  • Africa
  • African Americans
  • mass screening
  • prostate-specific antigen
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

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