Association of Race and Ethnicity With Prostate Cancer–Specific Mortality in Canada

Abstract

Despite extensive research, age, family history, race and ethnicity, and certain genetic sequence variants remain the only currently well-established risk factors for prostate cancer. Black men are purported to have an increased risk of early and aggressive prostate cancer. This higher risk classification for Black men has resulted in recommendations for earlier prostate cancer screening and evidence of distinctive treatment patterns. 1,2 However, the underlying data for these recommendations lack high-quality evidence, rendering the validity of these conclusions uncertain.Data from the Canadian health care system are well suited for studying the association of race and ethnicity and prostate cancer mortality, owing to Canada's diverse population and universal health care model. MethodsThis cohort study was approved by the Western University Institutional Research Ethics Board.Statistics Canada datasets were used for the research; these datasets incorporate implied consent from Canadian citizens and are subject to stringent reporting and confidentiality guidelines in accordance with the Statistics Act. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.Data from the Statistics Canada Canadian Census Health and Environment Cohorts were used. 3 The mandatory 1991 long-form census (administered to 20% of households) was linked with Canadian health care, tax, and mortality databases (including the Canadian Vital Statistics Death Database, the Canadian Cancer Registry, and the historical postal code file from tax records) to investigate the association of race and ethnicity with prostate cancer mortality in Canada. Individuals who completed the census chose from existing options to categorize their race and ethnicity, with an optional write-in response to describe their ancestry. The categories included in this study were

Prostate cancer screening in Black men in Canada: a case for risk-stratified care

“…32 A recent cohort study found no increase in prostate cancerspecific mortality among Black people in Canada after adjusting for nonbiological differences such as socioeconomic status and access to health care. 33 This finding contradicted earlier studies that proposed genetic differences as a major cause for elevated risks of prostate cancer in Black people. 19,20 It is, however, likely that genetic ancestry and societal barriers intersect, and further research is required to draw out such nuances.…”

Incidence, factors, and disparities related to cancer among Black individuals in Canada: A scoping review

“…43 The studies were published between 2007 and 2021, with seven being published in the past 5 years. [35][36][37]39,42,44,45…”

“…33,34,46,47 Six studies focused on immigrant populations 35,37,38,41,44,48 and three on ethnic or racial minorities. 32,45,49 The remainder of the studies assessed population-wide data that contained information concerning Black individuals. 36,39,40,42,43,50 Results on general aspects of cancer (not specified/ various)…”

“…Two studies have explored factors related to prostate cancer among Black individuals in Canada. 44,45 One was conducted with data from the Canadian health care system from 1992 to 2010. 45 that Black communities are particularly at risk for some cancers.…”

The Association between Cyclin Dependent Kinase 2 Associated Protein 1 (CDK2AP1) and Molecular Subtypes of Lethal Prostate Cancer

“…TP53 mutation affecting 50% of metastatic PCa cases are well known to serve as a prognostic biomarker of PCa, especially CRPC [ 8 ]. However, there remains conflicting results regarding the implementation of biomarker signatures, especially given variance between different ethnicities and the search for an effective biomarker continues [ 9 , 10 ].…”