Heterogeneous methodology of racial/ethnic classification may be responsible for the different risk assessments for prostate cancer between Black and White men in Brazil

Abstract

Objectives To evaluate if the different results of prostate cancer risk between black and white Brazilian men may be associated with the varying methodology used to define participants as either Blacks or Whites.Patients and Methods We evaluated median PSA values, rate of PSA level ≥4.0 ng/mL, indications for prostate biopsy, prostate cancer detection rate, biopsy/cancer rate, cancer/biopsy rate, and the relative risk of cancer between blacks versus whites, blacks versus non-blacks (browns and whites), non-whites (browns and blacks) versus whites, African versus non-African descendants, and African descendants or blacks versus non-African descendants and non-blacks.Results From 1544 participants, there were 51.4% whites, 37.2% browns, 11.4% blacks, and 5.4% African descendants. Median PSA level was 0.9 ng/mL in whites, browns, and non-African descendants, compared to 1.2 ng/mL in blacks, and African descendants or blacks, and 1.3 ng/mL in African descendants. Indications for prostate biopsy were present in 16.9% for African descendants, 15.9% of black, 12.3% of white, 11.4% for non-African descendants, and 9.9% of brown participants. Prostate cancer was diagnosed in 30.3% of performed biopsies: 6.2% of African descendants, 5.1% of blacks, 3.3% of whites, 3.0% of non-African descendants, and 2.6% of browns.Conclusions Median PSA values were higher for Blacks versus Whites in all classification systems, except for non-white versus white men. The rate of prostate biopsy, prostate cancer detection rate, and relative risk for cancer was increased in African descendants, and African descendants or blacks, compared to non-African descendants, and non-African descendants and non-blacks, respectively.

Prevalence and Factors Associated with High Concentration of Prostate-Specific Antigen: ELSIA Study

“…Giovannucci et al [ 7 ] conducted a follow-up study with men and demonstrated that African-American men had a higher incidence of PC. Romero et al [ 29 ] evaluated 1,544 men and observed a 4.0% higher prevalence of high PSA levels (≥4 ng/mL) in African and black descendants compared to whites and non-African descendants. In our study, there was no association between high levels of PSA between whites and blacks, however, individuals of brown color had a protective factor in relation to whites (PR = 0.26; 95% CI = 0.08–0.82).…”

“…In Brazil, several studies have not found differences between black and white individuals [ 29 , 30 , 31 , 32 ]. These results can be attributed to race miscegenation in the Brazilian population, but another potential source of bias may include the use of different methodologies to classify individuals into racial groups [ 29 , 33 , 34 ].…”

“…In Brazil, several studies have not found differences between black and white individuals [ 29 , 30 , 31 , 32 ]. These results can be attributed to race miscegenation in the Brazilian population, but another potential source of bias may include the use of different methodologies to classify individuals into racial groups [ 29 , 33 , 34 ]. The model of race/ethnicity/racial classification in Brazil is more complex than in other countries such as the USA and European models, the classification is usually self-reported in the ethnic/racial choice by the interviewee or made by the interviewer, using skin color as a basis, among other physical characteristics (facial features, hair texture, lip and nose shape), which can distort the results [ 33 , 34 ].…”

Predictors of high‐quality cord blood units

“…In the other study, the population was separated into five groups. Another difference between the studies is the fact that the population in North America has characteristics different from those of the Brazilian population …”