Burden Of Prostate Cancer Research Articles

Making informed decisions about prostate cancer testing: Locally tailored factsheets on the burden of prostate cancer in Australia

Making informed decisions about prostate cancer testing: Locally tailored factsheets on the burden of prostate cancer in Australia

Clinical and genomic factors associated with tumor mutational burden (TMB) in prostate cancer.

240 Background: TMB is an emerging biomarker to predict clinical benefit from immune checkpoint inhibitors (ICI). Although high TMB in prostate cancer is rare, and we sought to evaluate independent associations of TMB by clinical factors, prior treatment, and genomics. Methods: This study used the US-based nationwide de-identified Flatiron Health-Foundation Medicine prostate cancer clinico-genomic database. The de-identified data originated from approximately 280 US cancer clinics (~800 sites) between January 2011-March 2022. Multivariable linear regression model was used to assess independent prediction of TMB levels, which were log2+1 transformed to better normalize distribution. Data are expressed as (estimate, [95% CI], p-value). Results: The study included 2,748 tissue specimens: 51.7% were from the prostate, 10.3% from bone, and 14.6% from lymph nodes. Specimens from white patients comprised 61.2% of samples, with another 7.5% from Black, 1.1% from Asian, and 30% from other or unknown race patients. Of our cohort, 58.5%, 15.5%, and 26.0% were from patients who received 0, 1-24 months, and >24 months of androgen deprivation therapy (ADT), respectively. Also 19.7%, 1.8%, 11.4%, and 0.4% had any exposure to novel hormonal therapies (NHT), Radium-223, taxanes, and ICI, respectively. Higher TMB was independently associated with ADT use >24 months (0.16, [0.05-0.27], p=0.005) and Asian race (0.36, [0.03-0.69], p=0.034). Prior treatment with NHT, taxanes, or radium was not associated with higher TMB. Compared to prostate, bladder (0.22, [0.03-0.41], p=0.023), liver (0.27, [0.13-0.42], p<0.001), and other (0.29, [0.15-0.43], p<0.001) biopsy sites were associated with high TMB, but lymph node biopsy was not. MSI-high (2.30, [1.96-2.64], p<0.001), MSI-intermediate (0.51, [0.14-0.88], p=0.007), and MSI-unknown (0.84, [0.60-1.09], p<0.001) were associated with increased TMB. Individually altered genes associated with increased TMB included MLH1 (0.77, [0.31-1.24], p=0.001), MSH2 (1.09, [0.74-1.45], p<0.001), MSH3 (0.64, [0.018-1.11], p=0.006), MSH6 (0.94, [0.61-1.26], p<0.001), BRCA2 (0.56, [0.43-0.69], p<0.001), CDK12 (0.38, [0.24-0.53], p<0.001), FANCA (0.42, [0.07-0.77], p=0.02), MRE11 (0.87, [0.11-1.62], p=0.025), and PALB2 (0.83, [0.48-1.18], p<0.001). No individual gene was independently associated with lower TMB. Conclusions: TMB associates with MSI status and MMR genes. However, aside from associating with long term ADT use, TMB does not have strong association with prior systemic treatment. Certain biopsy specimen sites including bladder and liver have increased TMB but overall, the association is relatively weak in comparison to MMR genes and MSI status. This study allows better understanding of how prior treatments, clinical and genomic factors affect TMB status, which may add value to MSI status in predicting treatment response in advanced prostate cancer.

Global burden of prostate cancer attributable to smoking among males in 204 countries and territories, 1990–2019

IntroductionUnderstanding the latest global spatio-temporal pattern of prostate cancer burden attributable to smoking can help guide effective global health policy. This study aims to elucidate the trends in smoking-related prostate cancer from 1990 to 2019 using Global Burden of Disease (GBD) 2019 study data.MethodsData on prostate cancer attributable to smoking were extracted from Global Burden of Disease Study (GBD) 2019. The numbers and age-standardized rates on smoking-related prostate cancer mortality (ASMR) and disability-adjusted life years (ASDR) were analyzed by year, age, region, country, and socio-demographic index (SDI) level. Estimated annual percentage change (EAPC) was calculated to evaluate the temporal trends of ASMR and ASDR from 1990 to 2019.ResultsOf all prostate cancer deaths and DALYs globally in 2019, 6% and 6.6% were attributable to smoking, which contributed to 29,298 (95% CI 12,789 to 46,609) deaths and 571,590 (95% CI 253,490 to 917,820) disability-adjusted life-years (DALYs) in 2019. The number of smoking-related deaths and DALYs showed an upward trend, increasing by half from 1990 to 2019, while ASMR and ASDR declined in five sociodemographic indexes (SDI) regions, with the fastest decline in high SDI regions. For geographical regions, Western Europe and East Asia were the high-risk areas of prostate cancer deaths and DALYs attributable to smoking, among which China and the United States were the countries with the heaviest burden. The ASMR has decreased in all age groups, with the fastest decrease occurring in 75–79 years old. The ASMR or ASDR tended to increase in countries with the lowest SDI, but declined in countries with the highest SDI. The EAPC in ASMR or ASDR was highly negatively correlated with Human Development Index (HDI) in 2019, with coefficients 0.46.ConclusionThe number of smoking-related prostate cancer deaths and DALYs continued to increase globally, whereas its ASMR and ASDR have been decreasing. This substantial progress is particularly significant in developed regions and vary across geographic regions. Medical strategies to prevent and reduce the burden should be adjusted and implemented based on country-specific disease prevalence.

Nanobodies: a new potential for prostate cancer treatment.

The current progressive increase in the cancer burden of prostate cancer requires the exploration of new diagnostic and therapeutic approaches. Nanobodies are single-domain antibodies with the advantages of small size, high stability, easy processing and modification, which are increasingly used in the treatment of many types of cancer. This review analyzed the relevant literature in PubMed and other databases. In the retrieved literature, nanobodies are widely used in the treatment of prostate cancer. The preparation of nanobodies targeting PSA or PSMA is straightforward. For diagnostic purposes, nanobodies can be used in the preparation of biosensors for more sensitive identification of prostate cancer; for therapeutic purposes, nanobodies are used in the preparation of immunotoxic and ADC drugs. Preclinical in vivo and in vitro experiments have shown that this therapeutic approach is feasible. This article is a review of the above to provide new ideas for the treatment of prostate cancer. Compared with traditional antibodies, nano-antibodies have the advantages of small size, high stability, and high penetration. These advantages make nano-antibodies worthy to be widely used. Current studies have shown that nanobodies have advantages and future in the diagnosis and treatment of prostate cancer.

Association of Neighborhood Deprivation With Prostate Cancer and Immune Markers in African American and European American Men

Neighborhood variables may be factors in the excessive burden of prostate cancer among African American men. To examine associations between neighborhood deprivation, circulating immune-oncology markers, and prostate cancer among African American and European American men. A case-control study was conducted between January 1, 2005, and January 1, 2016. Participants included men with prostate cancer and age- and race-frequency-matched population controls. Participants were recruited at the Baltimore Veterans Affairs Medical Center and University of Maryland Medical Center; controls were obtained through the Maryland Motor Vehicle Administration database. National Death Index follow-up was performed through December 31, 2020, and data analysis was conducted from February 1, 2022, through October 31, 2022. 2000 Census-tract Neighborhood Deprivation Index as a standardized score. Primary outcomes included prostate cancer, all-cause mortality, and disease-specific mortality. Secondary outcomes included the National Comprehensive Cancer Network risk score and serum proteomes for 82 immune-oncology markers with pathway annotation. Participants included men with prostate cancer (n = 769: 405 African American, 364 European American men) and age- and race-frequency-matched population controls (n = 1023: 479 African American, 544 European American men). The median survival follow-up was 9.70 years (IQR, 5.77 years), with 219 deaths. Among 884 African American men, mean (SD) age at recruitment was 63.8 (7.6) years; mean (SD) age at recruitment among 908 European American men was 66.4 (8.1) years. In the multivariable logistic regression analysis with individual socioeconomic status adjustment, neighborhood deprivation was associated with 55% increased odds of prostate cancer among African American men (odds ratio [OR], 1.55; 95% CI, 1.33-1.81), but was not associated with the disease among European American men. Residing in the most-deprived vs least-deprived neighborhoods corresponded to 88% higher disease odds (OR, 1.88; 95% CI, 1.30-2.75) among all men and an approximate 3-fold increase among African American men (OR, 3.58; 95% CI, 1.72-7.45), but no association was noted among European American men. In Cox proportional hazard regression analyses, socioeconomic status-adjusted neighborhood deprivation was associated with an increased all-cause mortality only among African American men (hazard ratio [HR], 1.28; 95% CI, 1.08-1.53), whereas it was associated with metastatic disease and a 50% increased hazard of a prostate cancer-specific death among all men (HR, 1.50; 95% CI, 1.07-2.09). In analyses restricted to controls, neighborhood deprivation was associated with increased activity scores of serum proteome-defined chemotaxis, inflammation, and tumor immunity suppression. The findings of this study suggest that deprived neighborhood residency may increase the risk of African American men for prostate cancer and a related mortality, potentially through its association with systemic immune function and inflammation.

Automated quantification of PET/CT skeletal tumor burden in prostate cancer using artificial intelligence: The PET index

PurposeConsistent assessment of bone metastases is crucial for patient management and clinical trials in prostate cancer (PCa). We aimed to develop a fully automated convolutional neural network (CNN)-based model for calculating PET/CT skeletal tumor burden in patients with PCa.MethodsA total of 168 patients from three centers were divided into training, validation, and test groups. Manual annotations of skeletal lesions in [18F]fluoride PET/CT scans were used to train a CNN. The AI model was evaluated in 26 patients and compared to segmentations by physicians and to a SUV 15 threshold. PET index representing the percentage of skeletal volume taken up by lesions was estimated.ResultsThere was no case in which all readers agreed on prevalence of lesions that the AI model failed to detect. PET index by the AI model correlated moderately strong to physician PET index (mean r = 0.69). Threshold PET index correlated fairly with physician PET index (mean r = 0.49). The sensitivity for lesion detection was 65–76% for AI, 68–91% for physicians, and 44–51% for threshold depending on which physician was considered reference.ConclusionIt was possible to develop an AI-based model for automated assessment of PET/CT skeletal tumor burden. The model’s performance was superior to using a threshold and provides fully automated calculation of whole-body skeletal tumor burden. It could be further developed to apply to different radiotracers. Objective scan evaluation is a first step toward developing a PET/CT imaging biomarker for PCa skeletal metastases.

Burden of prostate cancer and relationship with the human development index (HDI) in Asia: A study of Global Burden disease in 2019.

Prostate cancer (PC) ranks as the second most commonly diagnosed neoplasia and the fifth cause of death in men with cancer, with an increasing trend in incidence. All accessible data sources from the 2019 Global Burden of Disease study were used to estimate the prevalence, mortality and disability-adjusted life years (DALY) and burden prostate cancer in Asia from 1990 to 2019. We estimated all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs) and DALYs. All estimates were presented as counts and age-standardized rates per 100 000 population, with uncertainty intervals (UIs). Concentration Index analysis and Concentration Curve were used to determine the relationship between Prostate cancer burden and human development index. The results showed that the percentage of changes in the incidence in 1990-2019 was positive in all countries of the Asian continent except for Afghanistan and Kyrgyzstan. The results of the concentration index showed that the incidence and mortality of prostate cancer is more concentrated in countries with a high HDI level. Examining the DALY, YLL and YLD index also showed the value of concentration index, which shows that DALY, YLL and YLD of prostate cancer are more concentrated in countries with high HDI level. Given that burden of prostate cancer are increasing in most Asian countries and are mostly concentrated in the HDI drawers, obtaining accurate estimates in these countries to prepare for the potential change in public health burden due to this disease which is very important.

Abstract A045: Investigating the biological determinants of poor mental health among ethnically diverse Black prostate cancer survivors: An iCCaRE consortium for prostate cancer in Black men project

Abstract Background: Black men across the world continue to bear the burden of prostate cancer (PCa). Although several factors account for this, studies have demonstrated that the adaptive constitutive biological factors associated with African ancestry contribute to the risk of disease development, disease aggression, and poor disease outcomes in Black men. However, the limited inclusion of Blacks in cancer biology studies limits the understanding of the extent to which biology influence outcomes among Blacks. Furthermore, beyond White-Black dichotomous disparity, there exists an under-exploited within-group geographical and ancestral disparities in the burden, clinical presentation, and outcomes of PCa among Black men globally. Aside from urological and sexual problems, Black PCa survivors experience poor mental health, with a concomitant reduction in the quality of life and overall survival. Hence, improving the overall well-being of PCa survivors requires an understanding of the biological determinants of mental health among diverse groups of Black PCa survivors. Methods: Structured questionnaires are being used to access fatigue, pain, depressive symptoms, health-related quality of life, and PCa-specific symptoms burden among within a cohort of ethnically diverse Black PCa survivors in Africa. This is linked with the salivary biomarkers of inflammation, hypothalamic-pituitary-adrenal axis activity, and tryptophan-kynurenine pathway in our studies population. Results: Data from fifty PCa survivors across different African ethnic groups (including, Yoruba, Igbo, Hausa) will be presented. This study will measure biological variables (e.g, inflammatory markers, cortisol, tryptophan, kynurenine, and serotonin) and survivors self-reported (e.g. health-related quality of life and psychoneurological symptoms) measures to better examine the interconnectedness between cancer-associated biomarkers and poor mental health. Conclusion: This study will lay an essential foundation for understanding the extent to which cancer associated-biological determinants contribute to the poor mental health of PCa survivors, unravels the within-group disparities in the mental health of Black PCa survivors, establish the contribution of genetics to poor mental health in Black PCa survivors and provide the opportunity for pharmacogenomic intervention that will improve the quality of life. Citation Format: Solomon O. Rotimi, Folakemi Odedina, Roxana Dronca, Kimlin Ashing, Ernest Kaninjing, Che Ngufor, Arnold Merriweather, Jennifer Crook, Manisha Salinas, Fathi Parisa, Sha’Reff Rashad, John McCall, Ebenezer Erefah, Ayinde Yahaya. Investigating the biological determinants of poor mental health among ethnically diverse Black prostate cancer survivors: An iCCaRE consortium for prostate cancer in Black men project [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A045.

Abstract A033: The iCCARE Consortium for Prostate Cancer in Black men: Creating a survivorship care plan for Black prostate cancer survivors

Abstract Background: Globally, Black men suffer the greatest prostate cancer (CaP) burden. Blacks are diagnosed more at advanced stages of CaP, greater morbidity and mortality and poorer survivorship outcomes. Blacks are exposed to adverse, discriminatory societal determinants. How these determinants impact the CaP disparities, in particular survivorship and health related quality of life inequities are understudied. Studies examining patient-reported outcomes of Black CaP survivors reveal heightened negative HRQOL sequelae, and depression, family, work and living situation instability due to cancer treatment and societal determinants of health (SDOH). SDOH is used mostly in Public Health to predict population health risk and outcomes, but rarely integrated into HRQOL research and practice. This project is novel by incorporating SDOH into the assessment and relief of HRQOL threats. Despite the Black CaP disparities in survivorship, there remains unacceptable lack of focus and prioritization to provide comprehensive relief. Methods: In response to this noticeable scientific gap, our requisite multidisciplinary investigatory team including Survivor-Advocate Investigators joins forces to achieve the study goal. We are employing community engaged research practice to create a CaP survivorship care plan (SCP) template targeted to Blacks. Our SCP will provide a comprehensive best-practice roadmap to document medical information with treatment history and status, along with relevant resources and health advisories to provide relief for unfavorable sequalae due to cancer and its treatments as well as improve quality of life for CaP survivors. We are building upon the Science of Survivorship, and Contextual Socioecological and the Behavioral Precision Medicine Models with full survivor-advocate partnership to create the SCP. This project to develop a SCP template employs an informative consensus panel to inform the initial SCP. Results: Based on advocate-survivor input and guidance, the SCP will include resources and tools focused on SDOH, treatment adherence, treatment side effects and symptom relief, co-occurring chronic conditions, cardio-protective strategies, and physical, emotional and social wellbeing towards improving in patient outcomes and HRQOL in Black CaP survivors. Data from the Engagement Core and Survivor-Advocate Community Advisory Board, and the preliminary SCP CaP for Black men will be presented at the meeting. Conclusion: Our Consortium builds upon the work of the multidisciplinary PIs, and provide team science approach with robust scientific methods to better understand and address the HRQOL needs of Black CaP survivors. Importantly, this research will make available a patient-centered SCP for CaP survivors, focused on Black men. The iCCaRE Consortium will use this SCP_CaP to inform the development of Artificial Intelligence interventions addressing medical, follow-up care, surveillance, social and emotional support, SDOH and health advisories that will be deployed on popular mobile platforms for greater reach and on-demand use. Citation Format: Kimlin T. Ashing, Folakemi T. Odedina, Cassandra N. Moore, Che Ngufor, Getachew A. Dagne, Fornati Bedell, Diana Londoño, John McCall, Arnold Merriweather, JoAnne S. Oliver, Rotimi Rotimi Oladapo. The iCCARE Consortium for Prostate Cancer in Black men: Creating a survivorship care plan for Black prostate cancer survivors [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A033.

Abstract B028: A point of prostate cancer diagnosis (PPCD) Virtual Robot Assistant (ViRA) intervention for newly diagnosed Black men: An iCCaRE consortium for prostate cancer in Black men project

Abstract Background: To date, the disparate burden of prostate cancer (CaP) in Black men (BM) is still poorly understood. More disconcerting is the limited access to effective, culturally tailored behavioral interventions to support BM diagnosed with CaP, especially at the point of prostate cancer diagnosis (PPCD). From the PPCD, the transition to CaP survivorship can be mentally and physically trying, especially for those lacking emotional and financial support. It is important to provide psycho-oncology support, address social determinants of health (SDOH) and make emotional support available to ethnically diverse BM at the PPCD. We are addressing the CaP disparities experienced by BM at the PPCD through the Inclusive Cancer Care Research Equity (iCCaRE) for Black Men Consortium. Aim: As part of the iCCaRE for Black men Consortium, the specific aim of our project is to develop a PPCD-based Augmented Reality (AR) intervention program, the iCCaRE PPCD Virtual Robot Assistant (ViRA). The ViRA is based on the established efficacy of six CaP care and survivorship (CaPCaS) video interventions, and will support BM at the PPCD. Methodology: The efficacy of six CaPCaS videos were established through formative research that included 17 BM in Florida. Based on pre- and post-test design, data were collected from participants using a structured survey tailored to each CaPCaS intervention: Prevention, Detection, Diagnosis, Treatment, Survivorship and Advocacy form. Following the efficacy study, the iCCaRE PPCD ViRA was proposed as one of five iCCaRE Science of Survivorship (S.O.S) projects to improve the quality of life of BM. Results: Most of the participants for the efficacy study reported that they were: US-born BM; married; college educated; earn less than $60,000; retired; have health insurance; have annual health examination; have a regular doctor; and were screened within the last year. The CaPCaS videos were found to be efficacious in improving attitude towards CaP screening, beliefs about CaP screening, perceived behavioral control and CaP knowledge. Participants also rated the quality of the videos high and expressed high satisfaction with the videos. We are currently in the development phase of the PPCD iCCaRE ViRA, which is based on behavioral science and health communications model. The ViRA will provide SDOH navigation services, psycho-oncology support and emotional support. The acceptance and usability of the iCCaRE ViRA will be established at urology clinics in Florida as part of the iCCaRE Consortium HEROICA Phase I study. We will test the central hypothesis that improving SDOH factors and CaPCaS-related factors will lead to an improvement in patient reported outcomes. Conclusion: We established the efficacy of the CaPCaS interventions in supporting BM across the CaP care continuum. The iCCaRE ViRA under development will target intervention at the PPCD and deliver a smart and connected personalized AR-enabled intervention system that will positively impact CaP diagnosis experience of BM. Citation Format: Folakemi Odedina, Che Ngufor, Arnold Merriweather, Deidre Pereira, Jennifer Crook, Fathi Parisa, Roxana Dronca, Ernest Kaninjing, Solomon Rotimi, Kimlin Ashing, Manisha Salinas, Sha’Reff Rashad, John McCall, Ebenezer Erefah, Ayinde Yahaya, Wes Sholes. A point of prostate cancer diagnosis (PPCD) Virtual Robot Assistant (ViRA) intervention for newly diagnosed Black men: An iCCaRE consortium for prostate cancer in Black men project [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B028.

Abstract IA025: Utilizing Visium spatial transcriptomics to investigate prostate cancer disparity in men of African descent

Abstract People of African descent suffer more from cancer compared to other racial groups in terms of morbidity and mortality. Surveillance, Epidemiology, and End Results (SEER) reports Black men and women to have the highest diagnoses and highest cancer death rate. The reported cancer disparity statistic is also reflected by cancer type; prostate cancer was shown to be one of the top causes of cancer death in all cancer types, and the second leading cause of death, after lung cancer, in men. Men of African Descent, however, have more than a 2-fold increased mortality rate of prostate cancer compared to other ancestral populations. Cancer is considered a genetic disease, and prostate cancer has a heritability of 58%. Most studies however, do not capture the genetic heterogeneity found in men of African Descent, nor histological and morphological profiles that would provide prognostic and diagnostic markers for targeted and personalized therapeutic treatment options. Visium Spatial Transcriptomics is a method that maps transcriptomics data to the location within the tissue region that is being analyzed. Instead of being limited to a small piece of DNA or RNA, spatial transcriptomics enables high-resolution assessment of spatial gene expression across tissue sections. This technology assiduously probes the transcriptome of tissues samples in an untargeted way. Spatial Transcriptomics involves cutting edge technology that provides great potential to capture the cellular landscape of men with the heaviest burden of prostate cancer. The Visium platform by 10X Genomics is able to interrogate more than 10,000 transcripts per capture region. The protocol involves a comprehensive process from tissue collection to next generation sequencing following a bioinformatics pipeline. The complete protocol from beginning to end requires a collaboration of clinicians, pathologists, basic scientists, and bioinformaticians. This means that access to resources is imperative to the success of this technique. Unfortunately, low resource institutions are at a disadvantage in being able to perform the entire protocol. This fact is yet another type of health disparity. This observation, however, provides great opportunities to establish collaborations with other institutions. Closing the gap between higher and lower resource investigations would be vital in addressing prostate cancer health disparity using spatial transcriptomics. I will share my observation, learning, experimentation, and joint participation effort experience with Visium Spatial Transcriptomics in my quest to understand the genetic architecture of men of African descent that has them at a prolific risk for prostate cancer. Citation Format: Maxine S. Harlemon, Ana C. Millena, Bor-Jang Hwang, Valerie Odero-Marah. Utilizing Visium spatial transcriptomics to investigate prostate cancer disparity in men of African descent [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr IA025.

Abstract B073: Quality of life indicators including mental health factors in CaPTC prostate cancer familial cohort study of men of African Ancestry in Nigeria, Cameroon, and United States

Abstract INTRODUCTION The Prostate Cancer Transatlantic Consortium (CaPTC) has the goal of better understanding the burden of prostate cancer among Black men of West African descent. While prostate cancer disproportionately affects Blacks around the world, little research is done to understand what mental health and social support play a role in prostate cancer risk factors. The purpose of this 10-year longitudinal study is to establish a cohort of U.S.-born Black men, West African-born Black men who reside in the U.S, and West African Black men in Africa who would be prospectively and longitudinally followed to better understand the cause of prostate cancer and how different factors might influence it. METHODS Study staff partnered with community-based organizations, events, and stakeholders to engage with the priority population. Snowball sampling was also used for recruitment. All participants were made aware of the longitudinal nature of the study and that they would be contacted every two years for follow-up. Informed consent was done in community settings electronically and on paper. Once consent was received, participants completed the survey with a unique identifier and filled out a Cohort Contact sheet. They were given the option to complete this on their own or with the help of the study staff. Study Staff would then measure participants’ weight, height, and waistline, to be recorded on the survey form. After this, participant saliva was collected and tracked with the unique identifier. All collected data was stored on RedCap and a Chi-squared test was utilized to identify statistical significance. RESULTS 803 participants are included in this data with 77 in Cameroon, 663 in Nigeria, and 59 in the United States. When asked about emotional support, 13.6% (US) 11.8% (Nigeria), and 14.3% (Cameroon) indicated never or rarely having emotional support. 5.8% of those in the United States, 5.6% of those in Nigeria, and 7.8% of those in Cameroon felt dissatisfied or very dissatisfied with their lives. The p-value for both was found to be <0.001, therefore, suggesting statistical significance. On the other hand, participants described having an average of 6.53 (US), 9.4 (Nigeria), and 8.26% (Cameroon) days where their mental health was not good. However, this was statistically insignificant with a p-value of .95. CONCLUSION Mental health issues have been on the rise since the COVID-19 pandemic. While many people of color have stigmatized needing mental health help, it is important to find ways to overcome this barrier in assessing mental health and social support needs. Future research should continue to ask mental health and social support questions in order to assess their role in prostate cancer risk factors. Citation Format: Jessica Otero, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adenji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, Jennifer Crook, Folakemi Odedina. Quality of life indicators including mental health factors in CaPTC prostate cancer familial cohort study of men of African Ancestry in Nigeria, Cameroon, and United States [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B073.

Abstract B032: Diet quality and physical activity of African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program

Abstract Background: In the United States, approximately 41,600 new cases of prostate cancer will be diagnosed in Black/African American men in 2022. Lifestyle can impact cancer survivorship, including recurrence risk, comorbidity burden and quality of life. The American Cancer Society has set physical activity and nutrition guidelines for cancer survivors that include plant-based eating and regular physical activity and strength training. However, many cancer survivors are unaware of these guidelines, and they often face challenges in adopting such behaviors. Men Moving Forward (MMF) is among the first community-based lifestyle intervention developed with and for African American Prostate Cancer Survivors (AAPCS). This study examines the diet and physical activity patterns of MMF participants at baseline. Methods: MMF is a 16-week group-based lifestyle intervention, led by local health coaches. Men complete surveys and physical assessments at baseline, post-intervention and at a 12-month follow-up. The VioScreen Food Frequency Questionnaire (FFQ) was used to obtain dietary intake and diet quality scores for participants at baseline. The Healthy Eating Index-2015 (HEI-2015) is used to assess adherence to the Dietary Guidelines for Americans (DGA) 2015-2020. Baseline HEI-2015 scores of men in the Multiethnic Cohort Study (MEC) were used to provide a population-based comparison. We also examined how many men received an HEI-2015 total score >80, reflecting an ideal diet for reducing premature death and chronic disease risk. Physical activity was measured using the Godin Leisure-Time Exercise Questionnaire (Godin) with an item added to query on frequency of strength training. Results: At baseline of MMF, 80 AAPCS completed the FFQ and 83 AAPCS completed the Godin. MMF participants had a mean age of 66.4 ± 6.86, 49.4% were married/living with a partner, and had varying incomes and education levels. Top comorbidities include hypertension (71%), obesity (51%), diabetes (31%), and hypercholesterolemia (48%). MMF participants had lower total HEI-2015 scores than MEC study men with average scores of 60.3 ± 11.0 and 65.6 ± 10.3, respectively. About half of the HEI-2015 component scores were similar between MMF and MEC participants. However, MMF participants reported 1 or more points higher component scores for “dairy” and “refined grains”, and 1 or more points lower scores for “seafood & plant proteins”, “fatty acids”, “sodium”, and “saturated fats” than their MEC counterparts. Although AAPCS in MMF reported similar HEI-2015 scores to typical American men, only 3 of the 80 AABCS at baseline reported HEI-2015 scores >80, highlighting a need for diet quality improvement. At baseline, 40% of participants were considered active and 33% reported strength training at least twice weekly. Conclusion: Data reflect the value of supporting AAPCS in lifestyle changes to improve dietary quality, physical activity and strength training. Few efforts have addressed lifestyle among AAPCS, despite high prostate cancer burden. Future reports will examine the efficacy of MMF. Citation Format: Margaret Y. Tovar, Patricia Sheean, Paula Papanek, Alexis Visotcky, Lola Awoyinka, Anjishnu Banerjee, Kathryn Bylow, Deepak Kilari, Kathryn Flynn, Toni Uhrich, Sophia Aboagye, Sandra Contreras, Kathleen Jensik, Melinda Stolley. Diet quality and physical activity of African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B032.

Cancer statistics in Chinese older people, 2022: current burden, time trends, and comparisons with the US, Japan, and the Republic of Korea.

Largely due to population ageing, the cancer burden from older people has been rising, which imposed considerable pressure on current Chinese healthcare system. We provide comprehensive information about cancer burden of Chinese older people based on the most recent data from National Central Cancer Registry of China. The logarithmic linear regression was used to project the current cancer burden in 2022, and Joinpoint regression was used for temporal trend analysis from 2000 to 2017. We also estimated cancer statistics of older people in the US, Japan and the Republic of Korea for comparisons. It is estimated that 2.79 million cases and 1.94 million deaths occur for Chinese older people, representing 55.8% and 68.2% of cases and deaths in all population in 2022. The overall cancer incidence rate gradually increased among older women, while the mortality rates declined for both sexes. Notably, approximately 10.0% of all cases and 17.7% of all deaths are from people aged over 80 years, and cancer incidence and mortality in this age group showed upward trends for women. Lung cancer and digestive cancers are the leading cancer types for Chinese older people. Compared with other countries, China has lower incidence rates but higher mortality rates for older people. The rapidly growing burden of prostate cancer, breast cancer, colorectal cancer, and declines in esophageal cancer, stomach cancer, and liver cancer among older people indicate the cancer pattern in China is being in a transition stage to that in developed countries. Our findings imply that it should be the national health priority to meet the growing demands for cancer diagnosis, treatment and care services from the older people as the rapid population ageing in next few decades.

Focal HDR brachytherapy boost to stereotactic radiotherapy (fBTsRT) for prostate cancer: a phase II randomized controlled trial.

For patients with a higher burden of localized prostate cancer, radiation dose escalation with brachytherapy boosts have improved cancer control outcomes at the cost of urinary toxicity. We hypothesize that a focal approach to brachytherapy boosts targeting only grossly visualized tumor volumes (GTV) combined with stereotactic radiotherapy will improve quality of life (QoL) outcomes without compromising cancer control. 150 patients with intermediate or high-risk prostate cancer will be enrolled and randomized 1:1 in a cohort multiple randomized clinical trial phase 2 design. Patients are eligible if planned for standard-of-care (SOC) high dose rate (HDR) brachytherapy boost to radiotherapy (RT) with GTVs encompassing < 50% of the prostate gland. Those randomly selected will be offered the experimental treatment, consisting of focal HDR brachytherapy boost (fBT) of 13-15Gy in 1 fraction followed by stereotactic radiotherapy (sRT) 36.25-40Gy in 5 fractions to the prostate (+/- 25Gy to the elective pelvis) delivered every other day. The primary endpoint is to determine if fBTsRT is superior to SOC by having fewer patients experience a minimally important decline (MID) in urinary function as measured by EPIC-26 at 1 and 2 years. Secondary endpoints include rates of toxicity measured by Common Terminology Criteria for Adverse Events (CTCAE), and failure-free survival outcomes. This study will determine whether a novel approach for the treatment of localized prostate cancer, fBTsRT, improves QoL and merits further evaluation. Trial registration This trial was prospectively registered in ClinicalTrials.gov as NCT04100174 as a companion to registry NCT03378856 on September 24, 2019.

The Emergence of Cancer Stem Cells in Early Diagnosed Prostate Cancer

The Emergence of Cancer Stem Cells in Early Diagnosed Prostate Cancer

Health Burdens and SES in Alabama: Using Geographic Information System to Examine Prostate Cancer Health Disparity.

Simple SummaryThe focus of the research was to examine the relationship between Socioeconomic status and prostate cancer in Alabama’s Black Belt region. The cancer rate in Alabama is high, and the state has one of the highest rates of prostate cancer in the USA. The research aims to identify probable reasons, raise awareness, and propose cancer prevention policies. The Geographic Information System, a robust technology, has been adopted to understand Alabama’s county-level prostate cancer incidence and mortality and its association with socioeconomic and health disparities. The analysis indicated an apparent socioeconomic disparity between the Black Belt and Non-Black Belt counties of Alabama. The poverty rate is higher in Black Belt counties. The data revealed that the preexisting condition of diabetes and obesity is closely associated with prostate cancer. Also, incidence and mortality disparities strongly relate to socioeconomic status, and the preexisting condition of obesity and diabetes adds to prostate cancer incidences. Poverty is the root course of inequalities in education, income, and healthcare facilities, particularly among African Americans, contributing to Alabama’s health burden of prostate cancer. The study proposes effective health policy intervention to prevent and reduce prostate cases and mortality among underserved communities in Alabama.Socioeconomic disparities influence the risk of many diseases, including cancer. The cancer rate in Alabama is high, and the state has one of the highest rates of prostate cancer in the USA. Alabama’s counties are embedded with socioeconomic disparities, politics, race, ethnicity, and oppression, among which social equity and socioeconomic status (SES) been closely associated with prostate cancer. The Geographic Information System (GIS) has become a valuable technology in understanding public health in many applications, including cancer. This study integrates Alabama’s county-level prostate cancer incidence and mortality and its association with socioeconomic and health disparities. We conducted robust data mining from several data sources such as the Alabama State Cancer Profile data, Alabama Department of Health, American Cancer Society, Center for Disease Control, and National Cancer Institute. The research method is the Geographic Information System (GIS), and we employed prostate cancer data within GIS to understand Alabama’s prostate cancer prevalence regarding SES. The GIS analysis indicated an apparent socioeconomic disparity between the Black Belt and Non-Black Belt counties of Alabama. The Black Belt counties’ poverty rate is also remarkably higher than non-Black Belt counties. In addition, we analyzed the median household income by race. Our analysis demonstrates that the Asian background population in the state earned the highest median income compared to non-Hispanic whites and the African American population. Furthermore, the data revealed that the preexisting condition of diabetes and obesity is closely associated with prostate cancer. The GIS analysis suggests that prostate cancer incidence and mortality disparities are strongly related to SES. In addition, the preexisting condition of obesity and diabetes adds to prostate cancer incidences. Poverty also reflects inequalities in education, income, and healthcare facilities, particularly among African Americans, contributing to Alabama’s health burden of prostate cancer.

SIOG2022-0023 - Global prostate cancer burden in middle-aged and older men

SIOG2022-0023 - Global prostate cancer burden in middle-aged and older men

The burden of prostate cancer in North Africa and Middle East, 1990-2019: Findings from the global burden of disease study.

BackgroundProstate cancer (PCa) is the second most prevalent cancer among men worldwide. This study presents estimates of PCa prevalence, incidence, death, years-of-life-lost (YLLs), years-lived-with-disability (YLDs), disability-adjusted-life-years (DALYs), and the burden attributable to smoking during 1990-2019 in North Africa and Middle East using data of Global Burden of Diseases (GBD) Study 2019.MethodsThis study is a part of GBD 2019. Using vital registration and cancer registry data, the estimates on PCa burden were modeled. Risk factor analysis was performed through the six-step conceptual framework of Comparative Risk Assessment.ResultsThe age-standardized rates (95% UI) of PCa incidence, prevalence, and death in 2019 were 23.7 (18.5-27.9), 161.1 (126.6-187.6), and 11.7 (9.4-13.9) per 100,000 population. While PCa incidence and prevalence increased by 77% and 144% during 1990-2019, respectively, the death rate stagnated. Of the 397% increase in PCa new cases, 234% was due to a rise in the age-specific incidence rate, 79% due to population growth, and 84% due to population aging. The YLLs, YLDs, and DALYs of PCa increased by 2% (-11.8-23.1), 108% (75.5-155.1), and 6% (-8.9-28.1). The death rate and DALYs rate attributable to smoking have decreased 12% and 10%, respectively. The DALYs rate attributable to smoking was 37.4 (15.9-67.8) in Lebanon and 5.9 (2.5-10.6) in Saudi Arabia, which were the highest and lowest in the region, respectively.ConclusionsThe PCa incidence and prevalence rates increased during 1990-2019; however, the death rate stagnated. The increase in the incidence was mostly due to the rise in the age-specific incidence rate, rather than population growth or aging. The burden of PCa attributable to smoking has decreased in the past 30 years.

Forecasting of overall and aggressive prostate cancer incident counts at the small area level

ObjectivesThis study aims to forecast overall and aggressive prostate cancer counts at the local government area (LGA) level over 10 years (2019–2028) in Victoria, Australia, using Victorian Cancer Registry (2001–2018) data. MethodsWe used the Age-Period-Cohort approach to estimate the annual age-specific incidence in each LGA and used Bayesian spatiotemporal models that account for non-linear temporal trends and area-level risk factors. We evaluated the models’ performance by withholding and comparing forecasts with the 2014–2018 data. ResultsThere were 80,449 prostate cancer cases between 2001 and 2018, with an overall increasing trend. Compared to 2001, prostate cancer incidence increased by 69%, from 3049 to 5167 cases in 2018. Prostate cancer counts are expected to reach 7631 cases in 2028, a further 48% increase. Unexplained area-level spatial variation was substantially reduced after adjusting for the area-level elderly population. Aggressive prostate cancer cases increased by 107% between 2001 and 2018 and are expected to rise by 123% increase in 2028. The proportion of aggressive prostate cancer cases will increase to 31% in 2028 from 20% in 2018. By 2028, overall and aggressive prostate cancer cases are projected to be increasing in 66% and 61% of LGAs. ConclusionProstate cancer cases are projected to rise at the state level and most LGAs in the next 10 years, with much steeper increases in aggressive cases. Population growth and an ageing population have primarily contributed to this rise besides prostate-specific antigen testing. These prediction estimates help inform prostate cancer burden and facilitate efficient healthcare delivery.