© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 5, 388-395,
March 7, 2001
© 2001 Oxford University Press
REPORT |
Racial and Ethnic Differences in Advanced-Stage Prostate Cancer: the Prostate Cancer Outcomes Study
Affiliations of authors: R. M. Hoffman, Medicine Service, Department of Veterans Affairs Medical Center, Albuquerque, NM, and New Mexico Tumor Registry, University of New Mexico Health Sciences Center, Albuquerque; W. C. Hunt, New Mexico Tumor Registry, University of New Mexico Health Sciences Center; F. D. Gilliland, A. S. Hamilton, Department of Preventive Medicine, University of Southern California, Los Angeles; J. W. Eley, Georgia Center for Cancer Statistics, Rollins School of Public Health, Emory University, Atlanta, GA; L. C. Harlan, A. L. Potosky, Division of Cancer Control and Prevention, National Cancer Institute, Bethesda, MD; R. A. Stephenson, Utah Cancer Registry and Division of Urology, University of Utah School of Medicine, Salt Lake City; J. L. Stanford, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, and Department of Epidemiology, University of Washington; P. C. Albertson, Division of Urology, University of Connecticut Health Sciences Center, Farmington.
Correspondence to: Richard M. Hoffman, M.D., M.P.H., General Internal Medicine 111GIM, Department of Veterans Affairs Medical Center, 1501 San Pedro Dr., S.E., Albuquerque, NM 87108 (e-mail: rhoffman{at}unm.edu).
Background: African-Americans have twice the risk of non-Hispanic whites for presenting with advanced-stage prostate cancer. To investigate the reasons for this difference, we evaluated the association between race/ethnicity and advanced-stage prostate cancer, adjusting for demographic, socioeconomic, clinical, and pathologic factors. Methods: A population-based cohort of 3173 men diagnosed with prostate cancer between October 1, 1994, and October 31, 1995, was analyzed. Medical record abstracts and self-administered survey questionnaires were used to obain information regarding race/ethnicity, age, marital status, insurance status, educational level, household income, employment status, comorbidity, urinary function, prostate-specific antigen level, tumor grade, and clinical stage. The odds ratio (OR) for advanced-stage prostate cancer was estimated with weighted logistic regression analysis. All P values were two-sided. Results: Clinically advanced-stage prostate cancers were detected more frequently in African-Americans (12.3%) and Hispanics (10.5%) than in non-Hispanic whites (6.3%). Socioeconomic, clinical, and pathologic factors each accounted for about 15% of the increased relative risk. After adjusting for all covariates, the risk remained statistically significantly increased for African-Americans (OR = 2.26; 95% confidence interval [CI] = 1.43 to 3.58) but not for Hispanics (OR = 1.23; 95% CI = 0.73 to 2.08). Conclusion: Traditional socioeconomic, clinical, and pathologic factors accounted for the increased relative risk for presenting with advanced-stage prostate cancer in Hispanic but not in African-American men.
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