Evaluating Racial/Ethnic Disparities in Lower Urinary Tract Symptoms in Men

Abstract

We examined whether there are racial/ethnic disparities in lower urinary tract symptoms in men. Racial/ethnic disparities were examined using the American Urological Association symptom index in 2 large cohorts, including the California Men's Health Study and the Research Program in Genes, Environment and Health. Prevalence and incidence were calculated in each age and race/ethnicity strata. Multivariate analysis was done to assess the association between race/ethnicity and lower urinary tract symptoms. The lower urinary tract symptom prevalence increased with age in each racial/ethnic category (p <0.05). The mean ± SD age adjusted American Urological Association symptom index score for black, Hispanic, other/mixed, non-Hispanic white and Asian men was 9.57 ± 5.83, 9.35 ± 6.30, 9.32 ± 6.22, 8.99 ± 5.89 and 8.41 ± 5.59, respectively. In multivariate models Hispanic and black men were at increased risk for moderate lower urinary tract symptoms than white men while only Hispanic men were at higher risk for severe lower urinary tract symptoms. Asian men were at lower risk for moderate or severe lower urinary tract symptoms than white men. The incident rate of lower urinary tract symptoms increased with increasing baseline age for almost all racial/ethnic groups (range 32% to 56%). Asian and Hispanic men were at lower risk for incident lower urinary tract symptoms than white men even after adjusting for sociodemographic factors, health related behaviors and comorbidity. Racial/ethnic disparities in lower urinary tract symptoms persist after accounting for putative and established risk factors.