The Risk of Prostate Cancer amongst Black Men in the United Kingdom: The PROCESS Cohort Study

Ben-Shlomo, Yoav; Evans, Simon; Metcalfe, Chris; Ibrahim, Fowzia; Patel, Biral; Gillatt, David; Anson, Ken; Corbishley, Catherine M.; Kirby, RS; Muir, Gordon; Chinegwundoh, Frank; Nargund, Vinod; Dorling, Danny; Thomas, Benjamin; Persad, Raj

doi:10.1016/j.eururo.2007.02.047

Cited by 135 publications

(116 citation statements)

References 18 publications

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“…Given that this is a much neglected issue this would benefit from examination elsewhere. The sample also reflects the limited ethnic diversity in the three study regions (North Wales, East Lothian and Thames Valley) and so the needs of Afro-Caribbean men, who have a higher incidence of prostate cancer, were not examined [61].…”

Section: Discussionmentioning

confidence: 99%

“I wish I’d told them”: A qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

O’Brien

Rose

Campbell

et al. 2011

Patient Education and Counseling

100

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Section: Discussionmentioning

confidence: 99%

“I wish I’d told them”: A qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

O’Brien

Rose

Campbell

et al. 2011

Patient Education and Counseling

100

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“…Our findings are in agreement with the consistently observed high risk of prostate cancer among African immigrants in the USA and the UK that remained high even after adjustment for a number of known and suspected risk factors. [27][28][29] Although immigrants from Middle Africa may not be representative of their counterparts in Africa, in the absence of a viable cancer register in Africa, it can be concluded that they reflect the high risk of prostate cancer in their countries of origin. On the other hand, immigrants from the Caribbean who have immigrated in ages younger than 40 years showed higher risk of prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown high risk of prostate cancer among immigrants from the Caribbean in the UK. 29 Interpretation is related to the real risk in country of origin. If one accepts high rates in the Caribbean, as some studies have shown earlier, 30 then better access to health care and diagnostic PSA test in Sweden could explain the increased risk observed in our study.…”

Section: Discussionmentioning

confidence: 99%

Risk of prostate cancer among Swedish‐born and foreign‐born men in Sweden, 1961–2004

Beiki

Ekbom

Allebeck

et al. 2009

Intl Journal of Cancer

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To elucidate the importance of environmental and genetic factors in prostate cancer etiology, we compared the risk of prostate cancer among foreign-born men to that of Swedish-born men in Sweden and to that in the country of origin. We estimated rate ratios (RRs) with 95% confidence intervals (CIs) adjusted for age, calendar period of year and education using Poisson regression in a cohort of 3.8 million men aged 45 years and older between 1961 and 2004. During the 45 years of follow-up, 8,244 and 187,675 cases of prostate cancer occurred among foreign-born and Swedish-born men, respectively. Overall, foreign-born men had a significantly 40% decreased risk of prostate cancer compared to Swedish-born men (RR 5 0.62, 95% CI 5 0.61-0.63). Men born in Middle Africa and in the Caribbean had an increased risk (RR 5 1.89, 95% CI 5 0.95-3.78 and RR 5 1.24, 95% CI 5 0.71-2.19, respectively). The overall risk in both strata of duration of residence or age at immigration was lower among immigrants compared to Swedish-born men. After additional adjustment for birthplace and age at immigration, although the risk remained lower among immigrants compared to Swedish-born, but it was increased among immigrants who stayed 35 years and longer compared to those who stayed shorter (RR 5 1.33, 95% CI 5 1.21-1.46). Both environmental and genetic factors seem to be involved in the etiology of prostate cancer. Duration of residence was an important factor affecting the risk among immigrants. Studies focusing on the etiology of prostate cancer specifically in African immigrants and their descendants and increasing preventive and diagnostic activities on old immigrants are recommended. ' 2008 Wiley-Liss, Inc. Key words: prostatic neoplasms; emigration and immigration; risk; SwedenProstate cancer is the most common cancer diagnosed among men in most western countries.1 About 75% of patients are diagnosed after 65 years. 2The incidence of prostate cancer varies considerably between countries and between different ethnic groups. The highest incidence rates have been observed in North America especially among African-American, Australia/New Zealand and Scandinavia, whereas the lowest rates have been observed in Asia, particularly in India, China and Japan.3 However, there is a general increase in incidence in most countries, with low as well as high incidence rates. [4][5][6] Studies on migrants that have focused either on comparing the risks in country of origin and host country, or on studying risk in relation to age at immigration and duration of residence are approaches to explore the importance of environmental and genetic factors in the etiology of most cancers. 7 Results from previous migrant studies on prostate cancer have been inconsistent. Several studies have shown that the incidence rate of prostate cancer in migrants is on a level between the incidence in the countries of origin and the incidence in the new country of residence, 8 whereas others have shown that the rates among migrants are similar to natives in the host countr...

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“…[1][2][3] The picture is less clear with regards ethnic differences in case fatality following prostate cancer diagnosis. There are several reasons why Black men may have a worse prognosis than their White counterparts.…”

mentioning

confidence: 99%

Investigating Black‐White differences in prostate cancer prognosis: A systematic review and meta‐analysis

Evans

Metcalfe

Ibrahim

et al. 2008

Intl Journal of Cancer

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The case-fatality rate following a diagnosis of prostate cancer is higher for Black men compared to White men. How this elevated rate arises is uncertain, with differences in disease biology, presentation, treatment and comorbidity having been suggested. A systematic search was conducted for articles that reported ethnic differences in overall-survival, prostate cancer specific survival (PSS) or biochemical recurrence. 48 articles met the inclusion criteria. Black men had worse overall survival (risk ratio 1.35, 95% CI 1.23-1.48) but this was not due to comorbidity alone as PSS and risk of biochemical recurrence were also elevated (1.29, 95% CI 1.13-1.47 and 1.34, 95% CI 1.23-1.46, respectively). Studies adjusting for clinical predictors and socioeconomic variables no longer supported a difference in overall survival (1.01, 95% CI 0.88-1.16), but continued to find an increased risk amongst Black men for PSS (1.13, 95% CI 1.00-1.27) and biochemical recurrence (1.25, 95% CI 1.11-1.41). Similar results were seen for studies from the pre-PSA era and free-health care settings. In contrast to others, studies of metastatic cancer did not find evidence of BlackWhite differences (p for interaction 5 0.01). In conclusion, Black men had a poorer prognosis which was not fully explained by comorbidity, PSA screening, or access to free health care, although few studies measure these factors well. Either management differences for local disease and/or biological differences may be behind Black-White differences in prostate cancer prognosis. ' 2008 Wiley-Liss, Inc.Key words: prostate cancer; ethnicity; prognosis; meta-analysis It is relatively uncontroversial to state that Black men have a greater incidence of prostate cancer than white men.1-3 The picture is less clear with regards ethnic differences in case fatality following prostate cancer diagnosis. There are several reasons why Black men may have a worse prognosis than their White counterparts.4,5 Some of these reasons may reflect socio-cultural differences that are amenable to intervention, whilst others may reflect genuine racial differences in cancer biology. These 2 types of explanations are not mutually exclusive and both may operate simultaneously.Possible socio-cultural explanations are: (i) Black men may have worse access to health care and therefore present later in the natural history of the disease at a more advanced stage. 6 (ii) In the US, more White men in the past have been diagnosed through screening.7 This will artefactually increase survival differences due to the phenomena of ''lead-time'' and ''length-time'' biases. (iii) Black men may be subject to differences in clinical management such that they are less aggressively investigated or treated. 8,9 (iv) Black men are more likely to have lower socioeconomic status, increased comorbidity and overall reduced life-expectancy compared to White men.10 These factors will increase the apparent difference in mortality rates even if there were no ethnic differences in the natural history of prostate cancer. How...

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The Risk of Prostate Cancer amongst Black Men in the United Kingdom: The PROCESS Cohort Study

Cited by 135 publications

References 18 publications

“I wish I’d told them”: A qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

“I wish I’d told them”: A qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

Risk of prostate cancer among Swedish‐born and foreign‐born men in Sweden, 1961–2004

Investigating Black‐White differences in prostate cancer prognosis: A systematic review and meta‐analysis

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