Prostate cancer disease severity and country of origin among black men in the United States

Abstract

Previous studies have reported higher rates of advanced Gleason score among black versus white men with prostate cancer in the United States. However, few studies have examined if elevated Gleason scores among black men vary by country of birth. We examined differences in prostate cancer disease severity among US black men born in the United States and in Jamaica, West Africa and other sub-Saharan Africa countries. Our study included 19 798 US-born, 267 Jamaican-born, and 246 West African-born black men diagnosed with prostate cancer during 2004-2009 in the 18 Surveillance Epidemiology and End Results population-based cancer registries. We evaluated the association of advanced Gleason score (7-10), as well as PSA levels and stage by country of origin adjusting for age, and county-level income. Among men with known Gleason score, the percentage of advanced Gleason score (scores 7-10) was 61.11% in Jamaican-born, 60.99% in West African-born and 58.26% in US-born black men (P-value=0.49). In a multivariable analysis among black men, there were no differences in advanced Gleason score (scores 7-10 versus 2-6) by country of origin. Mean PSA level (range 12.8-13.1 ng ml(-1)) did not vary among black men (P-value=0.94) in unadjusted and adjusted results. Similar Gleason score among US-born, African and Caribbean-born black men were observed. Future more detailed studies are needed to elucidate if these similarities are a result of similar early detection practices or shared risk factors.