Ghanaian Men Research Articles

Prostate-specific antigen, digital rectal examination, and prostate cancer detection: A study based on more than 7000 transrectal ultrasound-guided prostate biopsies in Ghana

Purpose of the studyThis study aims to determine the role of serum prostate-specific antigen (PSA) levels and digital rectal examination (DRE) in predicting the histological outcomes of prostate biopsies by analyzing a database of over 7000 patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsies. MethodsWe conducted a retrospective analysis of men who underwent TRUS-guided prostate biopsies at Korle Bu Teaching Hospital, a tertiary referral center in Accra, Ghana, from July 2005 to December 2022. The biopsies, which included 10 to 12 core samples, were prompted by PSA levels greater than 4.0 ng/mL, abnormal DRE findings, or both. We then correlated histopathology results with PSA and DRE findings. ResultsOut of 7,338 patients who presented for biopsy, 76.3% were between the ages of 60 and 79. Histology reports were available for 5,289 patients, of whom 2,564 (48.5%) were diagnosed with prostate cancer. Cancer detection rates based on PSA levels were as follows: 21.6% for PSA <4 ng/mL, 21.7% for PSA 4-10 ng/mL, 32.7% for PSA 10-20 ng/mL, 53.0% for PSA 20-50 ng/mL, 71.5% for PSA 50-100 ng/mL, and 92.0% for PSA >100 ng/mL. When DRE findings were classified according to the 2016 TNM System (AJCC 8th Edition) as T1, T2, T3, and T4, cancer detection rates were 26.8%, 51.8%, 87.6%, and 95.7%, respectively. The overall cancer detection rate was significantly higher with abnormal DRE findings (64.6% vs. 26.7%, p < 0.001). Additionally, 78.2% of the detected cancers were high-grade (Gleason score of 7 or more). ConclusionThis extensive study of Ghanaian men undergoing TRUS biopsies reveals a high prostate cancer detection rate, with nearly 80% of the detected cancers being high-grade. These findings underscore the importance of PSA and DRE in the early detection of prostate cancer and should be considered in patient counseling and discussions regarding the implementation of prostate cancer screening programs in this population.

Abstract A035: Protein quantitative trait loci analysis in diverse prostate cancer patients: A focus on angiogenesis

Abstract Prostate cancer exhibits notable disparities in mortality rates between African American (AA) and European American (EA) populations, with genetic ancestry and the social environment influencing both disease risk and lethality. Angiogenesis, the process of new blood vessel formation, plays a critical role in tumor progression and metastasis. However, the germline genetic contribution to the physiological variation in levels of circulating angiogenic markers, and the angiogenic process, is largely unknown. This study aims to explore the genetic underpinnings of angiogenesis in prostate cancer patients through a protein quantitative trait loci (pQTL) analysis. We analyzed 30 blood-based angiogenesis-related immuno-oncology markers in a cohort of 2,437 men from Ghana and the United States, comprising 1,330 controls and 1,107 prostate cancer cases. A comprehensive evaluation of 4,301,332 single nucleotide polymorphisms (SNPs) was conducted to investigate their associations with these markers across 3 population groups (Ghanaian, African American, and European American men). In this genome-wide pQTL we identified loci that associated with the levels of 13 markers (p &amp;lt;1.2 x 10-9). Our findings reveal that germline genetic variants may contribute to the variability in circulating angiogenic marker levels, or the systemic angiogenesis-inducing potential, with specific loci showing population-specific associations. We further link these circulating angiogenic markers to prostate cancer disease characteristics. Thus, our results suggest that germline genetic factors influence circulating levels of circulating angiogenesis-related proteins and thereby systemic angiogenesis, with a relationship to prostate cancer. Citation Format: Ashlie Santaliz Casiano, Hunter Schaumloffel, Huaitian Liu, Brittany Jenkins-Lord, Tsion Minas, Tiffany Dorsey, Stefan Ambs. Protein quantitative trait loci analysis in diverse prostate cancer patients: A focus on angiogenesis [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A035.

HIV Symptom Clusters Among Sexual Minority Men in Ghana, West Africa: A Cross-sectional Study.

The aims of this study were to determine if HIV symptoms among sexual minority men formed clusters and to examine the sociodemographic and clinical characteristics that are associated with these clusters. We analyzed cross-sectional data from Ghanaian sexual minority men (N = 225) living with HIV. We used both principal component analysis and multivariable linear regression. Our findings indicate that sadness (64.0%) and headache (62.7%) were the most prevalent symptoms among our sample. Seven symptom clusters were identified: neurological symptoms, psychological symptoms, gastrointestinal symptoms, dermatological symptoms, self-concept/self-esteem, weight/diet-related symptoms, and sleepquality and potential disturbances. Late HIV diagnosis was significantly associated with higher distress scores for all symptom clusters except for the self-concept/self-esteem and gastrointestinal symptoms clusters. The findings emphasize the importance of early HIV symptom identification.

Sociodemographic correlates of late HIV diagnosis among men who have sex with men (MSM) in Ghana

ABSTRACT Timely HIV diagnosis and medical engagement are crucial for effective viral load suppression and treatment as prevention. However, significant delays persist, particularly in Africa, including Ghana. This study focused on Ghanaian men whose route of exposure to HIV was through same-gender sexual contact (MSM), a group disproportionately impacted by HIV. Using structured surveys, we investigated the sociodemographic factors associated with late HIV diagnosis, a topic with limited existing research. Results indicate that older age groups were associated with an increased risk of late diagnosis compared to the 18–24 age group. Among the demographic variables studied, only age showed a consistent association with late HIV diagnosis. This study underscores the importance of targeted interventions to address HIV diagnosis disparities among MSM in Ghana, particularly for older age groups. The findings emphasize the need for tailored interventions addressing age-related disparities in timely diagnosis and engagement with medical services among this population. Such interventions can play a crucial role in reducing the burden of HIV within this community and fostering improved public health outcomes.

Mosaic chromosomal alterations in peripheral blood leukocytes of children in sub-Saharan Africa

In high-income countries, mosaic chromosomal alterations in peripheral blood leukocytes are associated with an elevated risk of adverse health outcomes, including hematologic malignancies. We investigate mosaic chromosomal alterations in sub-Saharan Africa among 931 children with Burkitt lymphoma, an aggressive lymphoma commonly characterized by immunoglobulin-MYC chromosomal rearrangements, 3822 Burkitt lymphoma-free children, and 674 cancer-free men from Ghana. We find autosomal and X chromosome mosaic chromosomal alterations in 3.4% and 1.7% of Burkitt lymphoma-free children, and 8.4% and 3.7% of children with Burkitt lymphoma (P-values = 5.7×10−11 and 3.74×10−2, respectively). Autosomal mosaic chromosomal alterations are detected in 14.0% of Ghanaian men and increase with age. Mosaic chromosomal alterations in Burkitt lymphoma cases include gains on chromosomes 1q and 8, the latter spanning MYC, while mosaic chromosomal alterations in Burkitt lymphoma-free children include copy-neutral loss of heterozygosity on chromosomes 10, 14, and 16. Our results highlight mosaic chromosomal alterations in sub-Saharan African populations as a promising area of research.

Exploring prostate cancer screening among men in Accra using the health belief model.

To explore the prevalence of prostate cancer screening among Ghanaian men and interrogate why some individuals screen for the disease and others do not. A cross-sectional questionnaire survey based on the Health Belief Model was used to collect data from 356 men aged 40 years and above. Data were collected between February and March 2021. The study was conducted in the Accra metropolitan area of the Greater Accra region of Ghana. Convenience sampling was used to recruit participants for the study. Although 86% of the respondents had heard about prostate cancer, only 23% had ever screened for it. Logistic regression analysis suggested that knowledge of the disease (OR = 1.19, CI 95% = 1.03 -1.38) and barriers to screening (OR = .87, CI 95% = .83 -.91) were statistically significant predictors of screening behaviour. HBM has limited predictive power as far as our study is concerned. We suggest increasing public education on prostate cancer and its screening methods. The cost of screening should also be made more affordable so as not to become a barrier. None declared.

Circulating trans fatty acids are associated with prostate cancer in Ghanaian and American men

The association between fatty acids and prostate cancer remains poorly explored in African-descent populations. Here, we analyze 24 circulating fatty acids in 2934 men, including 1431 prostate cancer cases and 1503 population controls from Ghana and the United States, using CLIA-certified mass spectrometry-based assays. We investigate their associations with population groups (Ghanaian, African American, European American men), lifestyle factors, the fatty acid desaturase (FADS) genetic locus, and prostate cancer. Blood levels of circulating fatty acids vary significantly between the three population groups, particularly trans, omega-3 and omega-6 fatty acids. FADS1/2 germline genetic variants and lifestyle factors explain some of the variation in fatty acid levels, with the FADS1/2 locus showing population-specific associations, suggesting differences in their control by germline genetic factors. All trans fatty acids, namely elaidic, palmitelaidic, and linoelaidic acids, associated with an increase in the odds of developing prostate cancer, independent of ancestry, geographic location, or potential confounders.

Imaging patterns of the arterial supply of the prostate gland in adult Ghanaian men.

Prostatic arterial embolization (PAE) is a novel procedure in West Africa and Ghana. A thorough understanding of the prostate artery's (PA) anatomy and pattern is required for successful prostatic arterial embolization and to guarantee targeted intervention. This study focuses onprostate arterial supply in adult males, including prevalence, variability, and imaging pattern. A prospective cross-sectional study was conducted, at Euracare Advanced Diagnostics and Heart Centre. Patients who presented for Computed Tomography Angiography of the pelvis were included in the study. A total of 52 males were included and 104 pelvic CT angiography (one for each side) were analyzed, including: prostatic artery diameter, prostatic gland volume and prostate artery branching pattern. The PA branching pattern was classified using de Assis et al. classification. Thirty-seven (71.15%) men had enlarged prostate volume (>30ml). On each side there was only one prostatic artery and no accessory one was found. Only three types of arterial branching were identified: type I, II,III. The type I artery was the most common origin 58.7% (61/104). PA originating from the anterior division of the internal iliac artery (type II) and the type III is from the internal pudendal artery, accounted for 16.3% (17/104) and 25% (26/104) respectively. The most frequent type of PA origin was type I followed by type III then II. Knowing the different and most frequent types of anatomy of PA may help standardization and effectiveness of the PAE in developing countries.

Predictors and consequences of overweight and obesity in the household: A mixed methods study on rural Ghanaian women and men farmers

Overweight/obesity (OW/OB) rates are increasing in Ghana. This study aims to identify the predictors of OW/OB in women, men, and at the household level (having at least one person as OW/OB in the household) in rural Ghana and examine local perceptions of the consequences of having an OW/OB person in the household. This was a cross-sectional mixed methods study. The quantitative data was a secondary analysis of the baseline data from the LinkINg Up (LU) project; a nutrition-sensitive agriculture intervention in eight rural communities in the Eastern Region of Ghana (ClinicalTrials.gov NCT03869853). The sample included 331 women and 205 men, 19-90 years old; there were 196 households that had both a participating woman and man (spouse, son, brother, or father). Logistic regression was used to assess variables associated with OW/OB in women (n=322), men (n=205), and households (n=196). Exposure variables included age, social support, mental health, self-efficacy, food security, the other family members’ OW/OB status, and others. Qualitative data included six focus group discussions (FGDs) (three with women and three with men, aged 22-69 years and recruited from the comparison arm of the LU project) were conducted in February-March 2022 in three of the eight project communities. A structured guide and a body figure instrument were used. The FGD recordings were translated and transcribed from Krobo to English. The analysis used an inductive thematic approach. Both women and men’s OW/OB were positively associated with age and wealth. Women’s OW/OB was negatively associated with age squared, and the score for mental health symptoms. Men’s OW/OB was negatively associated with being Krobo compared to other ethnicities. Households in the highest wealth tertile were 2.5-fold more likely to have at least one person who is OW/OB as compared to households in a lower wealth tertile. Participants expressed positive social consequences of having an OW/OB person for their families (for example respect). A person’s size was concerning only when it affected one’s ability to farm or make money, which would harm the household unit (for example lead to food insecurity, children dropping out of school). Having money was seen as a modifier for the negative effects. No negative consequences were perceived for OW people. The implications of the interruption of an OB person’s work on their family are worrisome and call for interventions that address poverty and food insecurity along with nutrition. Key words: Africa, farmer, household, social norms, perceptions, body image, overweight, obesity, predictors

Serum Adiponectin and Leptin Among Ghanaian Migrants in Amsterdam and Their Compatriots in Rural and Urban Ghana: The RODAM Study.

The rapidly rising cardiometabolic disease (CMD) burden in urbanizing sub-Saharan African populations and among sub-Saharan African migrants in Europe likely affects serum adiponectin and leptin levels, but this has not yet been quantified. To compare the serum levels of adiponectin and leptin among migrant, and non-migrant (urban and rural) populations of Ghanaian descent. Cross-sectional analysis of serum leptin and adiponectin in the multi-centre Research on Obesity and Diabetes among African Migrants (RODAM) study. Logistic-regression models were used to examine the association between these adipocyte-derived hormones after stratification (sex, geographic area) and adjustments for potential confounders. A total of 2518 Ghanaians were included. Rural participants had the highest serum adiponectin and lowest leptin levels compared to Amsterdam and urban Ghanaians (P < .001). In fully adjusted models, participants living in urban Ghana had significantly higher odds of hyperleptinemia compared to rural participants (women-odds ratio 2.88; 95% CI, 1.12-7.38, P = .028 and men 43.52, 95% CI, 4.84-391.25, P < .001). Urban Ghanaian men also had higher odds of elevated leptin: adiponectin ratio (6.29, 95% CI, 1.43-27.62, P = .015). The odds of hyperleptinemia were only higher in Amsterdam Ghanaian men (10.56; 95% CI, 1.11-100.85, P = .041), but not in women (0.85; 95% CI, 0.30-2.41, P = .759). There was no significant association between hypoadiponectinemia and geographical location in both sexes. Urbanization is associated with serum adiponectin and leptin levels after adjusting for confounding covariates in sub-Saharan Africans. These findings serve as a backdrop for further research on the role adipokines play in CMD epidemiology among Africans.

Urinary PCA3 a Superior Diagnostic Biomarker for Prostate Cancer among Ghanaian Men

Introduction Prostate cancer is one of the most commonly diagnosed cancers in men. Prostate-specific antigen (PSA) has been the biomarker of choice for screening and diagnosis of prostate cancer. However, inefficiencies exist with its diagnostic capabilities. This study thus evaluated the diagnostic and prognostic potential of urinary PCA3 as an alternative biomarker for prostate cancer in the Ghanaian population. Methods A hospital-based cross-sectional study was conducted at the Urology Department of the 37 Military Hospital, Accra, Ghana. A total of 237 participants aged 40 years and above with any form of suspected prostate disorder were recruited into the study after written informed consent was obtained. Total serum PSA levels was measured using the electrochemiluminescence method and transrectal ultrasound-guided systematic core needle biopsies were obtained from each study participant. Receiver operating characteristic curve (ROC) analysis was used to evaluate the diagnostic accuracies of serum PSA, DRE, and PCA3 as diagnostic tools for prostate cancer. These three diagnostic tools were also evaluated in various combinations to ascertain the combinations with the best diagnostic accuracy. Results Prostate cancer was diagnosed in 26.6% of the participants. Benign prostate hyperplasia and prostatitis were diagnosed in 48.5% and 24.9% participants, respectively. DRE had a sensitivity of 93.7% and a specificity of 12.1%. PSA had a sensitivity of 92.1% and a specificity of 16.1%. PCA3 had a sensitivity of 57.1% and a specificity of 85.6% and showed a better accuracy (AUC = 83.0) compared to PSA (AUC = 60.0) and DRE (AUC = 65.0) as individual diagnostic tools. The combination of DRE+PCA3 score had the best diagnostic accuracy (AUC = 0.80) with a sensitivity and specificity of 60.3% and 80.5%, respectively. Conclusion The urinary PCA3 assay showed a better diagnostic performance compared to serum PSA and DRE. PCA3 as a stand-alone and in combination with DRE could be a suitable complimentary marker in diagnosis and management of prostate cancer.

Knowledge of prostate health and food choice influence on the risk of prostate disorders among Ghanaian men

Understanding prostate health is vital for preventing, managing, and treating prostate disorders. Prostate disorder is a significant health challenge among men, and if not detected early, could lead to complications like cancer and death. Thus, knowledge of prostate health is essential for defining critical areas of intervention among men. This was a cross-sectional survey conducted among 894 Ghanaian men aged 40 to 70+ to assess their knowledge of prostate health and its influence on their food choices. The study was conducted in Greater Accra, Bono, and Northern Regions of Ghana. A structured questionnaire was employed to collect data on socio-demographics, knowledge of prostate health and consumption of foods related to prostate health. Two categories of foods, relating to prostate health were considered for the study: protective foods (fruits and vegetables) and high-risk foods (alcohol, meat, and meat products). Knowledge level scores were computed from the marks scored by participants on prostate health risk factors, causes, signs, symptoms and treatment, and nutrition and prostate health. Food choices were assessed based on the frequency of protective foods and high-risk foods intake. Associations between socio-demographic characteristics, knowledge level of prostate health, and food choices were examined using bivariate analysis, and multivariate regression analysis was conducted for possible predictors. The mean age of participants was 51.44 ±7.98. More than half of the participants (62.5%, n=559) had a high knowledge of prostate health. Participants with a family history of prostate disorders were approximately two times [OR (odds ratio) =1.973, p=0.041] more likely to have a high knowledge level of prostate health than those with no family history. Similarly, those diagnosed with prostate disorders were three times (OR = 2.736, p&lt;0.001) more likely to have a high knowledge level of prostate health than those who have never been diagnosed of any prostate disorder. Generally, participants consumed protective and high-risk foods related to prostate health. Participants with increased knowledge of prostate health were three times (OR=2.531, p&lt;0.001) more likely to consume protective foods. Knowledge about prostate health through experience positively impacts the consumption of fruits and vegetables. Efforts in Ghana to improve prostate health should include education on protective food choices to promote prostate health. Key words: Food choice, Knowledge, Men, Nutrition knowledge, Prostate health, Protective foods

Challenges of Inguinal Hernia Surgery in Ghana

Background: In Ghana inguinal herniais a very common cause of considerable morbidity and significant mortality especially in rural communities.Objective : To perform a brief review of the published data on the epidemiology of and the surgical output oninguinal hernia in Ghana.Method : In this review the author presents data from a series of recent publications derived from his work on inguinal hernia in Ghana. Other articles that also have data on inguinal hernia surgery in Ghana were selected in support of or to compliment the publications in possession of the author. The search terms used to select these articles were : inguinal hernia in Ghana, groin herniaepidemiology in Ghana, hernia repair, strangulated inguinal hernia, inguinal hernia surgery output in Ghana in Medline, Pubmed and Embase. All journal articles containing information on inguinal hernia epidemiology and surgical output betweenJanuary 1, 2000 and November 30, 2015 were selected and carefully analyzed for data on inguinal herniaprevalence and repair or operations.Results : Literature on inguinal hernia surgery in Ghana is mostly clinical reports based on analysis of hospital based patients. Two sources of population based data wereavailable but were nearly four decades apart. Based on tis data inguinal henria is veryprevalent in Ghana. However, surgical correction rates are very low leaving many men with longstanding untreated inguinal hernias.Conclusion : Inguinal hernia is very prevalent in Ghanaian men in both urban and rural communities. Access to hernia repair surgery is limited by patient education, health care costs and health facilitycapacity. Intervention is needed to build the capacity for increased hernia repair.

Socioeconomic determinants of use and choice of modern contraceptive methods in Ghana

BackgroundThe slow pace of fertility decline in Africa relative to other parts of the world has important implications for the region’s economic development. Modern contraceptive use is seen as important population control and family planning strategy by governments worldwide. This paper examines the socioeconomic determinants of modern contraceptive use and choice among Ghanaian men and women.MethodsWe use the most recent and nationally representative Ghana Demographic and Health Survey conducted in 2014. The analysis is observational, with no causal implications. Bivariate and multivariate methods are used to analyse the data. We first use logistic regression to explore the correlates of modern contraceptive use among Ghanaian men and women. Second, we explore the socioeconomic factors influencing the choice of modern contraceptive methods among contraceptive users using multinomial logistic regression. We classify the modern methods of contraception into three groups: long-acting reversible contraceptives (LARC), short-acting contraceptives (SAC), and permanent contraceptives.ResultsMarital status proves to be the most significant predictor for both men and women, with women in monogamous unions having a greater propensity to use modern methods of contraception (OR = 1.4, p < 0.00). We also find that different factors affect the use and choice of modern methods of contraception among men and women in Ghana. Muslim men had a higher likelihood than Catholics to choose the permanent (sterilisation) method (OR = 11.9, p < 0.05), while their female counterparts were 0.25 times less likely to choose sterilisation over SAC (p < 0.05). Moreover, women who ever tested for HIV had higher use of LAC than the SAC ((RRR = 1.6, p < 0.01). The modern contraceptive users (women) with at most basic education were more likely than those with tertiary education to choose LAC over SAC. Finally, rural women with health insurance were 0.75 times (p < 0.01) less likely to use modern methods of contraception.ConclusionsThe paper reiterates the need to intensify and sustain public health education on the health benefits of using modern methods of contraception among the adult population. The paper suggests that including family planning services on Ghana’s national health insurance benefits package is commendable. It can promote modern contraceptive use and curtail unwarranted population growth.

Serum proteomics links suppression of tumor immunity to ancestry and lethal prostate cancer

There is evidence that tumor immunobiology and immunotherapy response may differ between African American and European American prostate cancer patients. Here, we determine if men of African descent harbor a unique systemic immune-oncological signature and measure 82 circulating proteins in almost 3000 Ghanaian, African American, and European American men. Protein signatures for suppression of tumor immunity and chemotaxis are elevated in men of West African ancestry. Importantly, the suppression of tumor immunity protein signature associates with metastatic and lethal prostate cancer, pointing to clinical importance. Moreover, two markers, pleiotrophin and TNFRSF9, predict poor disease survival specifically among African American men. These findings indicate that immune-oncology marker profiles differ between men of African and European descent. These differences may contribute to the disproportionate burden of lethal prostate cancer in men of African ancestry. The elevated peripheral suppression of tumor immunity may have important implication for guidance of cancer therapy which could particularly benefit African American patients.

Ghanaian men and happiness: socioeconomic predictors

BackgroundAccording to neoclassical economics, happiness is related to increasing prosperity, but today financial gain as the sole source of happiness is demised by many factors such as education, health, and means of transportation. An emotional state of happiness can disturb health outcomes. AimThis study aimed to study happiness among Ghanaian men and their socioeconomic predictors. MethodologyA descriptive cross-sectional study design was used relying on data from Ghana Multiple Indicator Cluster Survey (MICS) 2017/18. Chi-square for two variables analysis and binary logistics for multiple variables analysis. ResultsThe national prevalence of estimated happiness among men recorded in this current study was 79.8% and overall estimated unhappiness was 20.2%. And predictors of happiness were age, higher educational attainment, regional association, ethnicity, body functional status, health insurance status, alcohol, and cigarette use. ConclusionOver one-five Ghanaian men are unhappy. That is the issue of happiness among Ghanaian men is a major issue and there is the need for policy enforcement towards education promotion, poverty reduction, and minimizing the use of a substance such as alcohol and cigarette.

Pain Burden in the CASiRe International Cohort of Sickle Cell Patients: United States and Ghana.

Sickle Cell Disease (SCD) is a genetic blood disorder affecting over 1 million people globally. The aim of this analysis is to explore the pain burden of patients with SCD in two countries: the United States and Ghana. The Consortium for the Advancement of Sickle Cell Research (CASiRe) was created to better understand the clinical severity of patients with SCD worldwide. Data regarding gender, SCD genotype, prior medical diagnoses, and validated pain burden measures were analyzed from the CASiRe database. The Sickle Cell Pain Burden Interview (SCPBI) was used to assess pain burden, the impact of pain on physical, emotional, and social function. Most subjects identified as Black/African American (n = 298, 97.0%). Patient ages ranged from 6 to 73 years. 35.9% resided in the United States, 64.1% resided in Ghana, 40.9% were men, and 58.7% were women. The mean SCPBI score for US SCD patients was 6.53(±5.89) vs 4.04(±5.10) for Ghanaian patients, P<0.001. Pain burden was higher in US men vs Ghanaian men (6.74(±5.68) vs 3.54(±4.46), P = .003) and in US women vs Ghanaian women (6.37 ± 6.06 vs 4.44(±5.54), P = .032). Pain burden was higher in US patients than Ghanaian patients for both the Hb SC/SBeta+ genotype (5.40(±5.29) vs 2.82(±4.86), P = .054) and Hb SS/SBeta0 genotype (6.79(±6.01) vs 4.49(±5.13), P = .003). Pain burden was significantly higher in SCD patients with comorbid conditions independent of geographic origin including stroke, cholecystectomy, gallstones, depression, and headache. US patients with SCD have a higher pain burden than Ghanaian patients. Further studies should investigate underlying contributors to pain burden in these populations and further explore the etiology of geographic differences in pain.

Everyday peacebuilding among Ghanaian men: ambiguities, resistances and possibilities

Dominant peacebuilding scholarship and praxis tends to focus on African men�s adherence to violent fragile masculinities in conflict prone-societies, and African masculinities are often approached, analysed, measured and theorised through externally derived standards and concepts. This article, by contrast, investigates the extent to which men can contribute to everyday peacekeeping. It does so by drawing on ethnographic interviews with men in northwestern Ghana. It illuminates how discourses and practices of male headship and breadwinner, as everyday masculine subjectivities, may contribute to creating fruitful possibilities for everyday peacebuilding subjectivities of men at the micro-levels. The article argues that approaching African masculinities through externally designed frameworks risks impoverishing critical understanding of the tensions, ambiguities, resistances and contestations of multiple configurations of masculinities beyond liberal, western-centric conceptualisations of masculinities. It further highlights that critical intervention seeking to address the systems and structures that may legitimise, and re/produce violence and social disorder must invest in carefully rethinking the everyday struggles of men within their locatedness. Peacebuilding scholars should invest in broadening discourses and representations of masculinities by offering nuanced understandings of how men can and are embracing peaceful and nonviolent masculinities in their everyday meaning-making.

Abstract PO-199: Determining the association between circulating fatty acids, immune oncological markers, and prostate cancer risk in a diverse cohort

Abstract Men of African descent, including African American (AA) men and Ghanaian (AFR) men, have a disproportionately higher burden of lethal prostate cancer (PCa) when compared to European American (EA) men. This increased mortality burden could be partially attributed to lifestyle factors including the intake of dietary fatty acids and their metabolism, but may also relate to differences in inflammation and immune function. Although the extent to which fatty acids are PCa risk factors remains controversial, the relationship between fatty acids, inflammation and immune function, and PCa in men of African descent remains largely unexplored. Therefore, the goal of our study was to characterize the relationship between circulating fatty acids, immune-oncological mediators, and PCa in the ethnically diverse NCI-Maryland and NCI-Ghana Prostate Cancer Case-Control studies, with an over-representation of men of African descent. A CLIA-certified, mass spectrometry-based assay was applied to measure 24 fatty acids in sera from 1,562 cases and 1,693 controls. Logistic regression analyses were performed on seven types of fatty acids including total, saturated, trans, cis-monounsaturated, omega-6, omega-3 fatty acids, and the omega 6:3 fatty acid ratio to explore disease associations by population group. Additionally, we measured 82 immune-oncological proteins in the same sera and explored their role as potential mediators of the relationship between fatty acids and PCa. Using this approach, we observed a significant association between trans fatty acid levels and the odds of developing PCa in all three racial/ethnic groups. Although AFR men were found to have the lowest level of trans fatty acids compared to AA and EA men, they still experienced significantly increased odds of developing PCa with increasing trans fatty acid levels. Exploratory mediation analyses found a relationship between Palmitelaidic trans fatty acid levels and two circulating proteins, CD27 and CXCL1, with protein levels being higher in men with elevated levels of circulating Palmitelaidic trans fatty acids and an increased risk of PCa. Our findings point to a previously unexplored oncogenic role of fatty acids and immune-oncological mediators in men of African descent with PCa. Citation Format: Brittany D. Lord, Tsion Minas, Tiffany H. Dorsey, Francine Baker, Wei Tang, Edward D. Yeboah, Yao Tettey, Richard B. Biritwum, Andrew A. Adjei, Evelyn Tay, James E. Mensah, Robert N. Hoover, Ann W. Hsing, Michael B. Cook, Stefan Ambs. Determining the association between circulating fatty acids, immune oncological markers, and prostate cancer risk in a diverse cohort [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-199.

Abstract PR-11: Blood levels of TNFRSF9 and PTN predict lethal prostate cancer among African American men

Abstract OBJECTIVE: Differentiating men who have lethal forms of prostate cancer from those with a more slow-growing disease remains a major challenge in clinical oncology. Risk stratification strategies are particularly needed for men of African descent who disproportionately bear the prostate cancer burden. Methods: Using a high throughput proximal extension assay, we simultaneously measured 82 immune-oncological proteins in the blood of 819 prostate cancer patients at diagnosis of whom 394 were African American (AA) and 425 were European American (EA). These patients were followed up for a median of 8.6 years since their diagnosis during which 57 died of prostate cancer while 202 died of all causes. To identify an immune-oncology protein signature predictive of lethal prostate cancer, we applied a cross-validated, regularized Cox regression model. Included in this model were the 82 immune-oncology proteins and 6 covariates of clinical significance (age, education, BMI, smoking history, aspirin use, and diabetes). Results: We did not identify a robust predictive signature of lethal prostate cancer for EA patients. However, for AA patients a signature primarily driven by tumor necrosis factor receptor superfamily member 9 (TNFRSF9) and pleiotrophin (PTN) (both positively associated with the risk of lethal disease) and regular aspirin use (negatively associated with risk) were the top predictors (P &amp;lt; 0.05) based on two selection criteria: the feature frequency and the weight of the features' contribution to the prediction. These features combined predicted prostate cancer-specific mortality with an accuracy of 83.7% (SE=3.8%). The two proteins alone, TNFRSF9 and PTN, predicted prostate cancer-specific mortality with an accuracy of 78.2% (SE=4.2%). AA prostate cancer patients with high levels (&amp;gt; median) of both TNFRSF9 and PTN in their blood at diagnosis had the worst prostate cancer-specific survival. By 10 years, 33% of cases with high levels of both TNFRSF9 and PTN died of prostate cancer compared to only 5% of cases with low levels of both or either of these proteins. Conclusions: Our study describes novel blood markers of lethal prostate cancer that can be used for risk stratification of AA patients at the time of diagnosis. AA patients with high levels of both TNFRSF9 and PTN in their sera had the highest risk of dying from prostate cancer. These markers may also be applicable to African prostate cancer patients since the blood-based immunome of Ghanaian and AA men are similar, as shown by our data. Citation Format: Tsion Zewdu Minas, Julián Candia, Tiffany H. Dorsey, Francine Baker, Wei Tang, Maeve Kiely, Cheryl J. Smith, Symone V. Jordan, Obadi M. Obadi, Anuoluwapo Ajao, Christopher A. Loffredo, Clayton Yates, Michael B. Cook, Stefan Ambs. Blood levels of TNFRSF9 and PTN predict lethal prostate cancer among African American men [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PR-11.