Tobago Prostate Survey: Prostate Cancer Risk in a Large Population-Based Study of Men of African Descent
Annual rept. 2 Nov 1998-1 Nov 1999
PITTSBURGH UNIV PA
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We hypothesized that the elevated risk for prostate cancer, observed in African Americans compared with whites, is present in all populations of African descent suggesting that genetic andor shared metabolic and lifestyle factors, rather than environmental factors, are the main determinants of elevated risk. We recruited 1088 males 95 Afro-Caribbean, aged 40-90 on the island of Tobago, Trinidad Tobago. Among 798 men with screening results, aged 50-79, serum prostate specific antigen PSA was elevated - 4 ngml in 31, digital rectal exam abnormal in 25, and either abnormal in 41. Prostate cancer was diagnosed in 102 of 208 men undergoing biopsy. The positive predictive value PPV for elevated PSA was 55. Few of the tumors 14 were of advanced Gleason grade 8-10 86 Gleason grade 5-7. No tumors of grade 1-4 were observed. The prevalence of screening-detected cancer was 13.4 of men aged 50-79. Elevated PSA rates, PPV for PSA, and prevalence of prostate cancer, were all much higher than observed in early screening studies in predominantly Caucasian populations. We conclude that this population has a high risk for prostate cancer, as observed in African Americans. Case control studies of genetic markers, and lifestyle and environmental factors are beginning.
- Anatomy and Physiology