Prostate Cancer Incidence Rates Research Articles

Management of Advanced and Metastatic Prostate Cancer: A Need for a Sub-Saharan Guideline.

The estimated incidence rate of prostate cancer in Africa was 22.0/100,000 in 2016. The International Agency for Research on Cancer (IARC) has cited prostate cancer as a growing health threat in Africa with approximated 28,006 deaths in 2010 and estimated 57,048 deaths in 2030. The exact incidence of advanced and metastatic prostate cancer is not known in sub-Saharan Africa. Hospital-based reports from the region have shown a rising trend with most patients presenting with advanced or metastatic disease. The management of advanced and metastatic prostate cancer is challenging. The available international guidelines may not be cost-effective for an African population. The most efficient approach in the region has been surgical castration by bilateral orchidectomy or pulpectomy. Medical androgen deprivation therapy is expensive and may not be available. Patients with metastatic castrate-resistant prostate cancer tend to be palliated due to the absence or cost of chemotherapy or second-line androgen deprivation therapy in most of Africa. A cost-effective guideline for developing nations to address the rising burden of advanced prostate cancer is warranted at this moment.

Prostate cancer incidence across stage, NCCN risk groups, and age before and after USPSTF Grade D recommendations against prostate-specific antigen screening in 2012.

We sought to determine the extent to which US Preventive Services Task Force (USPSTF) 2012 Grade D recommendations against prostate-specific antigen screening may have impacted recent prostate cancer disease incidence patterns in the United States across stage, National Comprehensive Cancer Network (NCCN) risk groups, and age groups. SEER*Stat version 8.3.4 was used to calculate annual prostate cancer incidence rates from 2010 to 2015 for men aged ≥50years according to American Joint Committee on Cancer stage at diagnosis (localized vs metastatic), NCCN risk group (low vs unfavorable [intermediate or high-risk]), and age group (50-74years vs ≥75years). Age-adjusted incidences per 100,000 persons with corresponding year-by-year incidence ratios (IRs) were calculated using the 2000 US Census population. From 2010 to 2015, the incidence (per 100,000 persons) of localized prostate cancer decreased from 195.4 to 131.9 (Ptrend <.001) and from 189.0 to 123.4 (Ptrend <.001) among men aged 50-74 and ≥75years, respectively. The largest relative year-by-year decline occurred between 2011 and 2012 in NCCN low-risk disease (IR, 0.77 [0.75-0.79, P<.0001] and IR 0.68 [0.62-0.74, P<.0001] for men aged 50-74 and ≥75years, respectively). From 2010-2015, the incidence of metastatic disease increased from 6.2 to 7.1 (Ptrend <.001) and from 16.8 to 22.6 (Ptrend <.001) among men aged 50-74 and ≥75years, respectively. This report illustrates recent prostate cancer "reverse migration" away from indolent disease and toward more aggressive disease beginning in 2012. The incidence of localized disease declined across age groups from 2012 to 2015, with the greatest relative declines occurring in low-risk disease. Additionally, the incidence of distant metastatic disease increased gradually throughout the study period.

Disparities in prostate cancer incidence and mortality rates: Solvable or not?

Prostate cancer (PCa) is recognized as a disease possessing not only great variation in its geographic and racial distribution but also tremendous variation in its potential to cause morbidity and death and it, therefore, ought not to be considered a homogenous disease entity. Morbidity and death from PCa are disproportionately higher in men of African ancestry (MAA) who are generally observed to have more aggressive disease and worse outcomes following treatment compared to men of European ancestry (MEA). The higher rates of PCa among MAA relative to MEA appear to be multifactorial and related to inherent differences in biological aggressiveness; a continued lack of awareness of the disease and methods of prevention; a lower prevalence of screen-detected PCa; comparatively lower access to quality healthcare as well as systemic and institutionalized disparities in the administration of optimal care to MAA in developed countries such as the United States of America where high-quality care is available. Even when access to quality healthcare is assured in equal access settings, it appears that MAA still have worse outcomes after PCa treatment stage-for-stage and grade-for-grade compared to MEA, suggesting that, inherent racial, ethnic and biological differences are paramount in predicting poor outcomes. This review has explored the different contributing factors to the current disparities in PCa incidence and mortality rates with emphasis on the incongruence in how research has been conducted in understanding the disease towards developing therapies.

Exploring health behaviors, quality of life, and support needs in African-American prostate cancer survivors: a pilot study to support future interventions.

Prostate cancer incidence and mortality rates are highest among African-American men. Comorbidity burden and quality of life (QOL) challenges are also high. Many factors drive these differences; health behaviors are important modifiable contributors. Studies document positive results for lifestyle interventions targeting NHW prostate cancer survivors, but inclusion of African-Americans is limited. We conducted an exploratory mixed-methods study with AAPCS to inform the development of a culturally relevant lifestyle intervention. Twenty-two AAPCS completed questionnaires and a discussion group on dietary and physical activity patterns, QOL, and unmet needs related to lifestyle changes. Seventy-five percent of the participants were overweight or obese, 82% had physical activity patterns considered insufficiently active and only 10% did resistance training at least twice weekly in accordance with current survivorship guidelines. Diets were high in saturated fat and sugar, low in fiber, fruit, and vegetable intake. PROMIS-29 scores indicated that AAPCS had worse physical functioning, pain interference, and sexual functioning, but less social isolation compared to the general population. Compared to other prostate cancer survivors, participants reported poorer status on all domains. Qualitative data highlighted barriers to healthy lifestyles including access, knowledge, and skills, as well as motivators including health benefits and building strength to feel more "manly." Participants shared high interest in programs to exercise, learn about affordable healthy eating, and bring survivors together to discuss survivorship issues. Lifestyle interventions targeting AAPCS are warranted. To increase impact of these efforts, consideration of environmental, cultural, and survivor contexts will be key.

Current and future burden of prostate cancer in Tunisia projections to 2030

Abstract Introduction Prostate Cancer is the second most common cancer among men worldwide. Current and future estimates on the burden of cancer are needed. The aim of this study was to assess prostate cancer burden in Tunisia in terms of disability adjusted life years (DALY) in 2017 and to perform projections by 2030. Methods DALYs for cancer are the sum of years of potential life lost due to premature mortality (Years Life Lost YLL) and the years lived with disability (YLD). Estimated data related to Burden of disease (Incidence rate, death rate, DALY, YLL and YLD)are obtained by the Institute for Health Metrics and Evaluation (IHME). Demographic data were provided by the National institute of statistics. The projection of DALYs for prostate cancer through 2030 was performed by a Poisson Regression analysis with Age -Period -Cohort (APC) using SPSS software, while using IHME estimated data for the period 1990-2017. Results In 2017, prostate cancer incidence rate and mortality rates among males in Tunisia were 24.17/100000 persons years and 7.08/100000 persons years respectively. Prostate cancer DALY values were 6548 (114 /100000). The number of YLLs was 5712 with a higher contribution of YLL in DALYS (87.2%). Without effective interventions, the number of DALYs due to prostate cancer would reach 10105 in 2030 with a standardized rate of 113/100000 persons years (IC 95% = [110/100000 to 116/100000]. Conclusions The burden of prostate cancer in Tunisia in 2017 is relatively high and will still rising until 2030. This highlights the urgent need to focus resources on disease prevention and in the improvement of treatment. Key messages The burden of prostate cancer is high in Tunisia in 2017. Need to focus ressources on disease prevention and in the improvement of treatment.

Global incidence of prostate cancer in developing and developed countries with changing age structures

To investigate the global incidence of prostate cancer with special attention to the changing age structures. Data regarding the cancer incidence and population statistics were retrieved from the International Agency for Research on Cancer in World Health Organization. Eight developing and developed jurisdictions in Asia and the Western countries were selected for global comparison. Time series were constructed based on the cancer incidence rates from 1988 to 2007. The incidence rate of the population aged ≥ 65 was adjusted by the increasing proportion of elderly population, and was defined as the “aging-adjusted incidence rate”. Cancer incidence and population were then projected to 2030. The aging-adjusted incidence rates of prostate cancer in Asia (Hong Kong, Japan and China) and the developing Western countries (Costa Rica and Croatia) had increased progressively with time. In the developed Western countries (the United States, the United Kingdom and Sweden), we observed initial increases in the aging-adjusted incidence rates of prostate cancer, which then gradually plateaued and even decreased with time. Projections showed that the aging-adjusted incidence rates of prostate cancer in Asia and the developing Western countries were expected to increase in much larger extents than the developed Western countries.

Relationship between Socioeconomic Status and Prevalent Prostate Cancer in the South Korea.

Background:Prostate cancer prevalence recently has increased among male adults in South Korea. But, few study has evaluated the reason. Therefore, we investigated the relationship between socioeconomic status and prevalent prostate cancer. Methods:This study enrolled 16,215 males aged 40 years and over who took part in the Korean National Health and Nutrition Examination Survey 2007-2016. In addition, we obtained the 2000-2016 age-standardized incidence rate and age-standardized mortality rate of prostate cancer from the Korean Statistical Information Service.Results:After adjusting for other covariates, prevalent prostate cancer was significantly associated with monthly household income (OR 3.71, 95% confidence interval [CI] 1.48–9.30, for highest vs. lowest) and significantly associated with education level (OR 3.66, 95% CI 1.54–8.70, for ≥ 13 vs. ≤ 6). In the analysis of the age-standardized incidence rate and the age-standardized mortality rate, the age-standardized incidence rate has soared from 2000 to 2011 and then decreased gradually, but the age-standardized mortality rate did not change. Conclusion:In our results, prevalent prostate cancer increased significantly with socioeconomic status and the increase in prevalent prostate cancer may be attributable to earlier detection rather than to a real increase in prevalence.

IJU this issue

This issue contains three Review Articles, four Original Articles and four Urological Notes. Huge differences in the incidence and mortality rate of prostate cancer were detected between the USA and Japan. Such differences, however, have been decreasing over time, and were only twofold in 2017. Ito et al. (Takasaki, Japan) describe the important issue of screening for prostate cancer. They propose their screening strategies based on baseline prostate-specific antigen with a reasonable incremental cost-effectiveness ratio. In their perspectives, prostate cancer management might not only be aimed at decreasing the mortality of prostate cancer, but also aimed at achieving a significant increase in the quality-adjusted life year with an acceptable incremental cost-effectiveness ratio. The cancer-specific mortality among patients with localized prostate cancer has been reported to be very low irrespective of the treatment modalities. Nakamura et al. (Hamamatsu, Japan) focus on the patients’ quality of life after external beam radiotherapy using X-ray for prostate cancer, compared with other modalities, including radical prostatectomy and brachytherapy. In conclusion, the patients’ quality of life after external beam radiotherapy is strongly related to the total dose, fractionation regimens, dose parameters of the critical organs, beam delivery techniques and treatment plan quality, with a trade-off between the radicality of external beam radiotherapy and potentially increased toxicity. Particle beam radiotherapy (RT) for prostate cancer in Japan has changed considerably, and it is eligible for insurance coverage as of April 2018. Ishikawa et al. (Tsukuba, Japan) review the results of previous particle beam RT studies compared with photon beam RT, and introduce ongoing studies and prospects to establish high-quality evidence for particle beam RT for prostate cancer. Androgen deprivation therapy (ADT), a standard treatment for metastatic and locally advanced prostate cancer, is known to increase the risks of osteoporosis and fractures. Kimura et al. (Tokyo, Japan) prospectively investigated changes in bone quality, turnover markers and bone mineral density before and after ADT in castration-sensitive prostate cancer. They found that bone quality markers did not change significantly after ADT, whereas bone mineral density decreased significantly after ADT. Bone turnover markers might play an important role in monitoring bone health during ADT. Simone et al. (Rome, Italy) carried out propensity score-matched analysis to compare long-term renal functional outcomes after either off-clamp partial nephrectomy (PN) or on-clamp PN in patients with cT1–2/N0 M0 renal tumors. This study shows that off-clamp PN is associated with a significantly higher probability of maintaining 100% estimated glomerular filtration rate after surgery compared with on-clamp PN in patients with good baseline renal function. It also showed that patients treated with on-clamp PN had a 7.3-fold increased risk of developing a severe chronic kidney disease during long-term follow up. Molecular-targeted therapies have been generally used for treatment of metastatic renal cell carcinoma (mRCC), resulting in improvement in prognoses of mRCC. Konishi et al. (Hirosaki, Japan) retrospectively investigated the impact of C-reactive protein/albumin ratio (CAR) on prognosis, and the effect of adding CAR in the International Metastatic Renal Cell Carcinoma Database Consortium model for prognosis discrimination in Japanese patients who were treated with first-line tyrosine kinase inhibitor for mRCC. They concluded that CAR is an independent predictor of prognosis in patients with mRCC. Predictive activity was significantly improved in the International Metastatic Renal Cell Carcinoma Database Consortium-CAR model compared with the International Metastatic Renal Cell Carcinoma Database Consortium model. Kam et al. (Sydney, Australia) compared the operative performance of two single-use digital flexible ureteroscopes (fURS) with a reusable video fURS in order to show that single-use fURS would have a similar performance to reusable fURS with a lower scope failure rate. In conclusion, these single-use scopes offer a feasible alternative to reusable fURS, especially in complex stone cases where the risk of scope damage is high. None declared.

Bounding Analyses of Age-Period-Cohort Effects.

For more than a century, researchers from a wide range of disciplines have sought to estimate the unique contributions of age, period, and cohort (APC) effects on a variety of outcomes. A key obstacle to these efforts is the linear dependence among the three time scales. Various methods have been proposed to address this issue, but they have suffered from either ad hoc assumptions or extreme sensitivity to small differences in model specification. After briefly reviewing past work, we outline a new approach for identifying temporal effects in population-level data. Fundamental to our framework is the recognition that it is only the slopes of an APC model that are unidentified, not the nonlinearities or particular combinations of the linear effects. One can thus use constraints implied by the data along with explicit theoretical claims to bound one or more of the APC effects. Bounds on these parameters may be nearly as informative as point estimates, even with relatively weak assumptions. To demonstrate the usefulness of our approach, we examine temporal effects in prostate cancer incidence and homicide rates. We conclude with a discussion of guidelines for further research on APC effects.

A review of social determinants of prostate cancer risk, stage, and survival.

Social determinants of health that have been examined in relation to prostate cancer incidence, stage at diagnosis, and survival include socioeconomic status (income, education), neighborhood disadvantage, immigration status, social support, and social network. Other social determinants of health include geographic factors such as neighborhood access to health services. Socioeconomic factors influence risk of prostate cancer. Prostate cancer incidence rates tend to be positively associated with socioeconomic status. On the other hand, low socioeconomic status is associated with increased risk of poorer survival. There are well-documented disparities in prostate cancer survival by socioeconomic status, race, education, and census tract–level poverty. The results of this review indicate that social determinants such as poverty, lack of education, immigration status, lack of social support, and social isolation play an important role in prostate cancer stage at diagnosis and survival. To address these social determinants and eliminate cancer disparities, effective interventions that account for the social and environmental contexts in which patients with cancer live and are treated are needed.

Forecasting annual incidence and mortality rate for prostate cancer in Australia until 2022 using autoregressive integrated moving average (ARIMA) models

ObjectivesProstate cancer is the second most common cause of cancer-related death in males after lung cancer, imposing a significant burden on the healthcare system in Australia. We propose the use...

Abstract LB-171: Global variation in prostate cancer incidence and mortality rates, 1980-2013

Abstract Context: Previous studies documented significant international variation in prostate cancer rates due to differences in detection practices, availability of treatment, and genetic factors. Objective: To provide updated contemporary prostate cancer incidence and mortality patterns across five continents using the most recent cancer incidence data from the International Agency for Research on Cancer and mortality data from the World Health Organization (WHO). Evidence acquisition: We present estimated age-standardized prostate cancer incidence and mortality rates by country and WHO regions for 2012 based on GLOBOCAN. We examined long-term (1980 onwards) trends in prostate cancer incidence and mortality rates for 38 countries with high quality population-based incidence and mortality data. Trends were expressed as annual percent change using Joinpoint model. We also examined short-term (most recent 5 years) trends in prostate cancer among 44 countries with available incidence data and 71 countries with available mortality data. Evidence synthesis: The highest incidence rates during the most recent 5 years are found in Brazil, Lithuania, and Australia, whereas the lowest incidence rates are found in Asia (India, Thailand, and Bahrain). The highest mortality rates are found in the Caribbean (Barbados, Trinidad and Tobago, and Cuba), sub-Saharan Africa (South Africa), parts of former Soviet Union (Lithuania, Estonia, and Latvia), whereas the lowest rates are found in Asia (Thailand and Turkmenistan). Of the 44 countries with high quality incidence data, prostate cancer incidence rates during the most recent five data years increased in 4 countries (with Bulgaria showing the largest increase), decreased in 7 countries (with the biggest decrease in the United States), and stabilized in the remaining 31 countries. During the same time period, in contrast, among the 71 countries considered for the mortality trend, rates decreased in 14 countries, increased in 3 countries, and remained stable in 54 countries. Conclusions: In 2012, prostate cancer was the most commonly diagnosed cancer among men in 96 countries and the leading cause of death in 51 countries. In the most recent 5 years of data examined, prostate cancer incidence and mortality rates are decreasing or stabilizing in most parts of the world. Future studies should monitor trends in mortality rates and late-stage disease to assess the impact of reduction in PSA testing in several countries. Citation Format: MaryBeth Freeman, Ahmedin Jemal. Global variation in prostate cancer incidence and mortality rates, 1980-2013 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-171.

Yield of prostate cancer screening at a community based clinic in Saudi Arabia.

Objectives:To estimate the incidence and prevalence of prostate cancer in Saudi Arabia.Methods:This is a retrospective cohort study including male patients aged 40 years and over. The prostate-specific antigen screening tests were carried out in a community-based clinic affiliated with King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia between September 2002 and December 2016.Results:A total of 2,160 male patients were included in the study. Of these, 1,521 (70%) were Saudi nationals and 639 (30%) were non-Saudi nationals. A total of 108 (5%) patients underwent a prostate biopsy. The biopsy results confirmed that 31 (2%) Saudi patients and 6 (0.93%) non-Saudi patients had prostate adenocarcinoma. The age-standardized incidence rate of prostate cancer in the Saudi male population is 70 per 100,000 males. Nearly two-thirds (71%) of the Saudi patients’ prostate cancer was found to be in the early stages.Conclusion:The prevalence of prostate cancer in the Saudi male population is higher than that reported by the Saudi Cancer Registry; however, it is low compared with prevalences in developed countries. The mortality rate is also very low. Prostate-specific antigen screening in Saudi Arabia should not be carried out routinely; instead, it should only be carried out on an individual basis.

Abstract 834: Epigenome-wide profiling of DNA methylation in peripheral blood leukocytes and the prognosis of prostate cancer patients in African Americans

Abstract Introduction: DNA methylation at CpG sites plays important roles in cancer development and progression. Hypermethylation of the promoter regions of tumor suppressor genes leads to gene silencing whereas global hypomethylation may affect chromosome structure and cause genomic instability. African Americans have higher incidence and mortality rates of prostate cancer than other ethnic groups. The goals of this study are to investigate the role of global DNA methylation in prostate cancer aggressiveness and identify CpG site methylations as predictors of aggressive prostate cancer in African Americans. Methods: We measured global DNA methylation level of long interspersed nucleotide elements (LINE-1) and subtelomeric repeat (D4Z4) in leukocyte DNA from ~300 African American prostate cancer patients and compared their methylation levels between different clinicopathological variables at diagnosis. We then analyzed the association of the LINE-1 and D4Z4 methylation with the risk of biochemical recurrence (BCR) using a multivariate Cox proportional hazards model. In addition, we used the Kaplan-Meier survival function and log-rank tests to assess BCR-free survival associated with D4Z4 methylation.. We also used Illumina’s HumanMethylationEPIC beadchip to profile 850K CpG site methylation in leukocytes and analzyed their associations with prostate cancer aggressiveness. Results: There was no significant differences in the methylation level of LINE-1 between clinically defined aggressive and non-aggressive PCa at diagnosis and LINE-1 methylation was not associated with BCR either. However, the methylation of subtelomeric region D4Z4 was associated with BCR. Patients with higher methylation of D4Z4 exhibited an increased risk of BCR (HR=3.47, 95% CI, 1.10 - 10.97) compared to patients in the lower methylation after adjustment of age, BMI, smoking status, pack year, D’Amico risk groups, and treatments. In Kaplan-Meier survival analysis, patients with higher D4Z4 methylation level had a significantly shorter BCR-free survival time than those with lower methylation level (log rank P = 0.0071). When analyzing individua CpG site methylation, we identified a number of CpG site that can distinguish aggressive from non-aggressive prostate cancer and found a CpG methylation signature that can identify a subgroup of patients with aggressive prostate cancer in African Americans. Conclusions: These data suggest that methylation in the subtelomeric region D4Z4 may be able to predict worse prognosis of patients. Individual CpG site methylation may be promising biomarkers for the identification of aggressive prostate cancer in African Americans. Citation Format: Junfeng Xu, Chia-Wen Tsai, Wen-Shin Chang, Da-Tian Bau, Jian Gu. Epigenome-wide profiling of DNA methylation in peripheral blood leukocytes and the prognosis of prostate cancer patients in African Americans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 834.

Abstract 5305: Reexpression of LSAMP, a gene frequently deleted in African American prostate cancers, suppresses tumor growth and β-catenin activity

Abstract Introduction: African American (AA) men have the highest prostate cancer incidence and mortality rates in the US. The biological contribution to this disparity, however, is not well understood. LSAMP inactivation has been implicated in several cancers, and was recently identified in prostate cancer. A higher frequency of LSAMP inactivation has been observed in AA prostate cancer, and this aberration has been associated with a significantly greater risk of disease progression. In the characterization of LSAMP in prostate cancer cells lines, we found the copy number to be variable and the expression to be low or undetectable. LNCaP, MDA PCa 2B, and DU 145 prostate cancer cell lines were stably transduced to express LSAMP in an inducible or constitutive manner. LSAMP expression in these cell lines resulted in reduced cell proliferation, and induced a reversion to indolent cell-cell, and cell-extra-cellular-matrix adhesion characteristics, consistent with its tumor suppressive role. LSAMP expression also resulted in the down-regulation of receptor tyrosine kinases EPHA3, FGFR2, and FGFR4, and reduced activation of their downstream ERK and AKT pathways. Several Integrins were also up-regulated upon LSAMP expression. Additionally, β-catenin localization was altered, suggesting a potential reduction in transcriptional activity. We assessed the tumor suppressive function of LSAMP further, using in vitro assays and in vivo mouse models. Methods: LSAMP expressing and control DU 145 cells were used to investigate the tumor suppressive function of LSAMP in vivo. Athymic nude mice were injected either subcutaneously, to determine effect of LSAMP expression on prostate tumor growth rates, or intravenously, to determine effect of LSAMP expression on tumor formation. We performed the TOPflash/FOPflash luciferase reporter assay to determine whether LSAMP expression modulates transcriptional activity of β-catenin in vitro. Results: LSAMP expression resulted in a significant inhibition of tumor growth in the subcutaneous xenograft model. In the intravenous xenograft model, LSAMP expression resulted in a reduced incidence of distant metastases. Consistent with the negative modulation of signal transduction, and β-catenin localization previously observed, LSAMP expression resulted in a reduction of β-catenin transcriptional activity in vitro. Conclusion: These studies provide in vivo evidence of the suppressive function of LSAMP in prostate tumors, corroborating previous in vitro and clinical findings. LSAMP expression reduced tumor growth rates, and incidence of distant metastases. LSAMP expression also reduced β-catenin transcriptional activity in vitro. These findings provide further support for a biological mechanism underlying the aggressive prostate cancer phenotype observed with LSAMP inactivation. Citation Format: Kevin Babcock, Taduru Sreenath, Charles P. Xavier, Inger L. Rosner, Shiv Srivastava, Albert Dobi, Shyh-Han Tan. Reexpression of LSAMP, a gene frequently deleted in African American prostate cancers, suppresses tumor growth and β-catenin activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5305.

Abstract 4183: Recruiting African-American prostate cancer patients for biobank research

Abstract Significant racial disparities exist in prostate cancer (PCa) incidence and mortality rates. Exploration of the basis for disparities would be enhanced by access to data and biological specimens on men of African Ancestry (AA). Unfortunately, AA men remain underrepresented in cancer biorepositories. To address this gap, we have embarked on an effort to create a state-wide biospecimen bank focused on AA men with PCa in Florida. The objective is to collect and manage patients’ data, outcome information, and biospecimens (i.e., tumor tissue samples and saliva) from diverse AA men for research. The objective is to collect and manage patients’ data, outcome information, and biospecimens who have been diagnosed with PCa in Florida. Self-identified AA PCa patients, diagnosed between 2013 and 2017, who were living in Florida at the time of diagnosis were identified through the Florida State cancer registry. Potential participants were mailed packets describing the study, with follow-up by telephone to answer questions and obtain informed consent. Interested patients were screened for eligibility and asked to complete a questionnaire, provide a saliva sample, and provide permission to obtain their tumor tissue sample. Patients were offered up to $30 for participating in the study. The Florida Cancer Registry reported a total of 7,960 AA PCa cases during the ascertainment period. Information packets were sent to 4,898 AA. A total of 116 were found to be ineligible mainly due to deceased or non-English speaking patients. To date, 796 have consented to participate, 1,175 declined ether by mail (n=185) or phone (=985), 740 could not be located, and 2,033 have not responded to the initial information packet/phone after total of 5 attempts. This yields a participation rate of 16.3% (796/4,898). The adjusted participation rate, or the percentage of participants who consented to participate out of those who had communication with the research team, is 41% (796/1,959). Primary reasons for declining include patients stating that they are not interested (72%), too sick (8%), or too busy (5%). A significant inverse association was found between current age and participation rate (p&amp;lt;0.0001) but not insurance status. Older AA PCa patients were found to be less likely to participate in the study. A significant association was also found between Gleason score and participation rate. AA men who had a more aggressive form of PCa (higher Gleason score) were more likely to participate in the study (p&amp;lt;0.01). Our results demonstrate that recruiting Blacks/African-American PCa patients in the biobank study using a cancer registry is feasible, yet difficult. Despite prevailing recruitment challenges, we implemented a diverse of recruitment methods to increase reach. These recruitment methods helped identify additional avenues for targeting this population to increase participation and, ultimately, address cancer disparities among this population. Citation Format: Jennifer Damonte, Siddhartha Roy, Carmen Benson, Kala Jamison, Hyun Park, Allan Pollack, Shahla Masood, Changdong Yeo, Young-chul Kim, Jasreman Dhillon, Kosj Yamoah, Julio Pow-Sang, Thomas A. Sellers, Clement K. Gwede, Jong Y. Park. Recruiting African-American prostate cancer patients for biobank research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4183.

Trends and age-period-cohort effect on incidence and mortality of prostate cancer from 1990 to 2017 in China

ObjectivesThe incidence and mortality trends of prostate cancer remain unknown in China. We examined secular trends in prostate cancer incidence and mortality rates and the net age, period, and cohort effects on them. Study designTrends were estimated using joinpoint regression, and the net age, period, and cohort effects were estimated by an age-period-cohort (APC) model with an intrinsic estimator (IE) algorithm. MethodsAge-specific mortality rates of prostate cancer (1990–2017) were collected from the Global Burden of Disease (GBD) 2017 study, and the average annual percent change (AAPC) and relative risks (RRs) analyzed by joinpoint regression and APC model. ResultsAge-standardized rates significantly rose by 2.75% (95% confidence interval [CI]: 2.6, 2.9) for incidence but declined by 0.26% (95% CI: −0.4, −0.2) for mortality from 1990 to 2017. The joinpoint regression analysis showed that incidence rates significantly rose in all age groups, but mortality rates decreased in these age groups over the past three decades. In addition, compared to the younger age groups (15-19, 20-24, 25-29, 30-34, 35-39 and 40-44 age group), the older age groups (50-54, 55-59, 60-64 and 75-79 age group) showed more substantial increases in incidence and slighter declines in mortality. The age effect on incidence and mortality showed sharp increasing trends from 40 to 79 years, and period effect showed both of them continuously increased with advancing period, but cohort effect showed substantial decreasing trends from 1917–1921 to 2002–2006 birth cohort. ConclusionsAge effect on incidence and mortality presented an increasing trend in older people, and period effect showed increasing trends. The incidence rate of prostate cancer is increasing at an alarming rate in all age groups, which may adversely impact the mortality rates. Mortality began to increase since 2005; thus, timely intervention should be conducted, especially for earlier birth cohorts at high risk.

Screening for prostate cancer: History, evidence, controversies and future perspectives toward individualized screening.

Differences in the incidence and mortality rate of prostate cancer between the USA and Japan have been decreasing over time, and were only twofold in 2017. Therefore, countermeasures against prostate cancer could be very important not only in Western countries, but also in developed Asian countries. Screening for prostate cancer in the general population using transrectal ultrasonography, digital rectal examination and/or prostate acid phosphatase began in Japan in the early 1980s, and screening with prostate-specific antigen and digital rectal examination has been widespread in the USA since the late 1980s. Large- and mid-scale randomized controlled trials on screening for prostate cancer began around 1990 in the USA, Canada and Europe. However, most of these studies failed as randomized controlled trials because of high contamination in the control arm, low compliance in the screening arm or insufficient screening setting about screening frequency and/or biopsy indication. The best available level1 evidence is data from the European Randomized Study of Screening for Prostate Cancer and the Göteborg screening study. However, several non-urological organizations and lay media around the world have mischaracterized the efficacy of prostate-specific antigen screening. To avoid long-term confusion about screening for prostate cancer, leading professional urological organizations, including the Japanese Urological Association, are moving toward the establishment of an optimal screening system that minimizes the drawbacks of overdetection, overtreatment and loss of quality of life due to treatment, and maximizes reductions in the risk of death as a result of prostate cancer and the development of metastatic prostate cancer.

Predicting future cancer incidence by age and gender.

1559 Background: Cancer remains a substantial and unique burden on society. While the impact of changing demographics on cancer incidence has previously been characterized (Smith et al, JCO, 2009), this has not been done with updated population data. Our objective was to update projections on the number of new cancer diagnoses in the United States by age and gender through 2040. Methods: Population-based cancer incidence data were obtained using SEER 18 delay-adjusted data. Population estimates were made by age, race, and gender using the 2010 US Census data population projections to calculate future cancer incidence rates. Trends in age- adjusted incidence rates for 23 cancer types were calculated as previously described (Edwards et al, Cancer, 2014). Results: From 2020 to 2040 the projected total cancer incidence will increase by almost 30% from 1.86 million to 2.4 million. This increase is due to the projected increase in population growth, particularly in older individuals. The population of older adults will represent a growing proportion of total cancer diagnoses. Specifically, patients ≥65 years old will make up 69% of all new cancer diagnoses, while 13% of new diagnoses will be in patients ≥85 years old by 2040 (see Table). Cancer diagnoses in females are projected to rise 27%, while male cancer diagnoses are projected to increase by 32% from 2020 to 2040. The incidence rates for lung, colorectal, and prostate cancer are expected to decline, while those for thyroid, liver, melanoma and myeloma are expected to increase. Conclusions: The landscape of cancer care will continue to change over the next several decades. The burden of disease will remain substantial and will continue to disproportionately affect older adults. The growing proportion of older cancer patients and changes in site-specific cancer incidence rates remain of particular interest. These projections should help guide future health policy and research priorities. [Table: see text]

Detection of human papillomavirus type 18 oncogen E7 in patients with prostate cancer

Introduction . High prostate cancer (PC) incidence rates testify to importance of research into genesis of the given disease and means of its prevention. The item of oncogenic human papillomaviruses (HPVs) participance in PC origination is still being the subject of debates. If association of PC with HPV is proven prophylaxis of the given disease becomes possible by means of inoculating boys with the vaccines made for cervical cancer (CC) prevention.Objective: to test whether prostate tissues surgically removed from PC patients harbor oncogen E7 of HPV18 – the second most common HPV type responsible for CC.Materials and methods . The study was carried out on prostate glands of 17 PC patients surgically treated in N.N. Blokhin National Medical Research Center of Oncology. Detection of HPV18 oncogen E7 was done by polymerase chain reaction. To elevate polymerase chain reaction sensitivity DNA was isolated from homogeneous cell populations collected by means of microdissections from cryopreserved PC specimens.Results . Amplification products corresponding to HPV18 oncogen E7 were registered in tests from 2 PC patients.Conclusion . HPV18 oncogen E7 was detected in surgically removed prostate tissues of 2 PC patients. In the aggregate with our previous result (7 HPV16-positive PC cases in the same group of 17 patients) the given result enables one to presume participance of oncogenic HPVs in PC genesis. The problem deserves further study.