Tobago Prostate Survey: Prostate Cancer Risk in a Large Population-Based Study of Men of African Descent PDF Download
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Author: Clareann H. Bunker
Publisher:
ISBN:
Category :
Languages : en
Pages : 57
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Book Description
We hypothesized that the elevated risk for prostate cancer, observed in African Americans compared with whites, is present in all populations of African descent suggesting that genetic and/or shared metabolic and lifestyle factors, rather than environmental factors, are the main determinants of risk. The specific aims were to conduct a population based prostate cancer screening of the male residents, aged 50-79, on the Caribbean island of Tobago (recruitment goal, 2346 men) in order to estimate the screening detected prevalence rate of prostate cancer, and to conduct a pilot case control study (200 men) of conventional risk factors and molecular markers. This study, which we believe is the first involving screening a large Afro- Caribbean population diagnosed prostate cancer among the first 1645 screened men, aged 50-79, residing on the island of Tobago. Our data from this study support our hypothesis that, as observed in African American men, Afro-Caribbean men experience a high risk for prostate cancer. Results from the pilot case control studies suggest that sex hormone related polymorphisms and surrogate hormone measures are related to prostate cancer. This Tobago population of West African descent shares considerable genetic ancestry with African Americans and provides a uniquely valuable opportunity for the study of prostate cancer risk. The data emerging from this study is expanding our understanding of the contribution and interaction of environmental, genetic and metabolic factors to risk for prostate cancer. We expect that these findings will enable us to reduce the risk for prostate cancer among men of West African descent.
Author: Clareann H. Bunker
Publisher:
ISBN:
Category :
Languages : en
Pages : 57
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Book Description
We hypothesized that the elevated risk for prostate cancer, observed in African Americans compared with whites, is present in all populations of African descent suggesting that genetic and/or shared metabolic and lifestyle factors, rather than environmental factors, are the main determinants of risk. The specific aims were to conduct a population based prostate cancer screening of the male residents, aged 50-79, on the Caribbean island of Tobago (recruitment goal, 2346 men) in order to estimate the screening detected prevalence rate of prostate cancer, and to conduct a pilot case control study (200 men) of conventional risk factors and molecular markers. This study, which we believe is the first involving screening a large Afro- Caribbean population diagnosed prostate cancer among the first 1645 screened men, aged 50-79, residing on the island of Tobago. Our data from this study support our hypothesis that, as observed in African American men, Afro-Caribbean men experience a high risk for prostate cancer. Results from the pilot case control studies suggest that sex hormone related polymorphisms and surrogate hormone measures are related to prostate cancer. This Tobago population of West African descent shares considerable genetic ancestry with African Americans and provides a uniquely valuable opportunity for the study of prostate cancer risk. The data emerging from this study is expanding our understanding of the contribution and interaction of environmental, genetic and metabolic factors to risk for prostate cancer. We expect that these findings will enable us to reduce the risk for prostate cancer among men of West African descent.
Author: National Institute Of Justice (Nij)
Publisher: BiblioGov
ISBN: 9781249920069
Category :
Languages : en
Pages : 54
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Book Description
The National Institute of Justice (NIJ) is the research, development and evaluation agency of the US Department of Justice. The NIJ is dedicated to improving knowledge and understanding of crime and justice issues through science. NIJ provides objective and independent knowledge and tools to reduce crime and promote justice, particularly at the state and local levels. Each year, the NIJ publishes and sponsors dozens of research and study documents detailing results, analyses and statistics that help to further the organization's mission. These documents relate to topics like biometrics, corrections technology, gun violence, digital forensics, human trafficking, electronic crime, terrorism, tribal justice and more. This document is one of these publications.
Author: Rasmi Girijavallabhan Nair
Publisher:
ISBN:
Category :
Languages : en
Pages : 195
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Book Description
In 2018, the United States Preventive Services Task Force (USPSTF) recommended that African American men and those with a family history of prostate cancer should discuss the pros and cons of PSA testing with their physician and engage in shared decision making. Identifying risk factors of prostate cancer, calculating individualized prediction of the risk of prostate cancer, and ensuring that the patients are well informed with knowledge to understand these risks so as to easily make decisions, are extremely important in shared decision making. The overarching goal of this dissertation is to assist in these three steps and facilitate shared decision making in a high-risk population. Aim 1 assessed the association of demographic characteristics, clinical markers and genitourinary symptoms with the diagnosis of prostate cancer (Aim 1a), as well as with the diagnosis of significant prostate cancer (Aim 1b), in a high-risk population. A nested case-control study for Aim 1a and a case-control study for Aim 1b was conducted using the Prostate Risk Assessment Program (PRAP) data, which enrolls African American men and those with a family history of prostate cancer. Multivariate conditional logistic regression was used to assess the association between the risk factors for any prostate cancer, while multivariate logistic regression was used for clinically significant prostate cancer. The risk of any prostate cancer increased with increasing age, presence of family history and increasing PSA levels, while the risk of significant prostate cancer was associated with increasing PSA level. This suggests that PSA level, as a continuum, is extremely important while predicting prostate cancer, especially significant prostate cancer within a high-risk population. Using Aim 2, we compared the performance of two prostate cancer risk calculators, Prostate Cancer Prevention Trial - Risk Calculator 2.0 (PCPT-RC 2.0) and the European Randomized Study of Screening for Prostate Cancer -Risk Calculator 3/5 (ERSPC-RC 3/5) to predict any prostate cancer and clinically significant prostate cancer in a high-risk American population. All men who underwent prostate biopsy with the PRAP data registry since 1996 were included in the study. The probability of being diagnosed with any prostate cancer and significant prostate cancer (Gleason score > 6) was calculated using the online versions of PCPT-RC 2.0 and ERSPC-RC 3/5. The performance of these calculators was compared using calibration (calibration plot and calibration-in-the-large), discrimination (comparing AUC curves using DeLong's method) and decision curve analysis (to assess clinical utility). The calibration suggested that both risk calculators under-predicted the probability of any prostate cancer while PCPT-RC 2.0 over-predicted the probability of significant prostate cancer. Analysis of the AUC curves suggested that the PCPT-RC 2.0 (AUC: 0.59, 95% CI 0.52 to 0.66) showed a trend towards better discrimination for any prostate cancer as compared to ERSPC-RC 3/5 (AUC: 0.55, 95% CI 0.48-0.63, p= 0.3819). Similarly, PCPT-RC 2.0 (AUC: 0.71, 95% CI 0.61-0.82) showed a trend towards better discrimination for significant prostate cancer as compared to ERSPC-RC 3/5 (AUC: 0.63, 95% CI 0.51 to 0.75, p= 0.2335). PCPT-RC 2.0 proved to be clinically beneficial to predict significant prostate cancer in the range of lower prediction thresholds. These results suggest that the PCPT-RC 2.0 is superior to ERSPC-RC 3/5 in a high-risk American population. Aim 3 utilized a systematic review of the decision aids used to improve prostate cancer knowledge, improve risk perception, reduce confusion, involve in shared decision making or utilize PSA tests in men at high-risk of prostate cancer, defined as those with African descent or those with a family history of prostate cancer. Data was extracted by searching MEDLINE, CINAHL, EMBASE, and PsycINFO via Ovid and EBSCOhost. After screening titles and abstracts, the resulting full-text articles were assessed for inclusion and exclusion criteria. A data extraction table was created, and the methodological quality of the studies was assessed based on three criteria - randomization, double blinding and intention-to-treat analysis. Due to the clinical heterogeneity of the studies, a descriptive analysis of all the studies was conducted and tabulated. A total of 2605 articles were retrieved after literature search, of which 8 articles met the inclusion criteria and were included in the qualitative analysis. Of these 8 articles, 6 were targeted at those who were African American or those with an African descent and 2 articles included interventions targeted at those with a family history of prostate cancer. Majority of the studies targeted at African American men demonstrated an improvement in knowledge and reduction in decisional conflict in the intervention group compared to the control group. The two studies that included men with a family history of prostate cancer did not show any change in knowledge or decisional conflict in the intervention group compared to the comparison group. All studies were of low quality, except one which was medium quality. Thus, this review unveiled that tailored decision aids would be helpful in improving knowledge and reducing decisional conflict in African American men while decision aids designed for men with family history of prostate cancer would not significantly change prostate cancer knowledge or decisional conflict compared to the standard decision aid. Thus, one of the tailored decision aids can be used to help African American men improve their knowledge of prostate cancer and reduce decisional conflict, while the standard decision aid can be used in men with a family history of prostate cancer. These conclusions can be assimilated into the USPSTF recommended shared decision-making sessions between the patients and the physicians.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 26
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The purpose of the Minority Population Focussed Training Program was to prepare the trainee to conduct research in the area of excess burden of prostate cancer among African American men, with excess burden defined as greater incidence, later stage at diagnosis, less access to state of the art treatment, or excess mortality from the disease. The goals were to examine results from previous research, and to develop new research. Refining measures of prostate cancer burden was a special focus of this work. During the six month project, the trainee reviewed 120 studies and task force reports on prostate cancer. Three sources of data on prostate cancer were obtained for analyses: the SEER Cancer Incidence data, the State of Maryland Cancer Registry data, and zip code%specific rates for Baltimore City. The major findings focussed on the wide variation in prostate cancer burden among African Americans, and the need to analyze cancer patterns by combining data from a variety of sources. One unanswered question from existing research is the extent to which socioeconomic disadvantage can explain some of these racial differences in cancer burden. The need for geographically based analyses led the trainee to develop and submit proposals for large scale projects examining prostate burden among Maryland men, using GIS techniques to link Registry data with environmental, social and health care data.
Author: Motolani Eniola Ogunsanya
Publisher:
ISBN:
Category :
Languages : en
Pages : 606
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The purpose of this study was to determine the factors related to young black men's intention to screen for prostate cancer as well as their engagement in prostate cancer risk-reduction behaviors. The study tested the significance of the constructs -- age, attitude (direct and indirect), social influence, comfortability, cues to action, health screening experiences and knowledge -- in predicting young black men's intention to screen for prostate cancer; as well as the significance of the constructs -- age, cues to action, exercise and knowledge -- in predicting engagement in prostate cancer risk-reduction behaviors. Demographic/personal factors were also explored in related to the model predictors. Web-based and paper-pencil surveys were administered to 279 black men aged between 18 - 40 years from the Austin area. Three focus groups were conducted to collect information regarding young black men's behavioral beliefs toward prostate cancer screening as well as their comfortability with prostate examinations. The number of usable surveys was 267. Using direct and indirect measures, the combination of attitude, social influence, comfortability (indirect model), and knowledge explained 41.0 and 43.0 percent of the variance in intention to screen for prostate cancer, respectively; with social influence being the strongest predictor ([Beta]=0.41; p
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 6
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African American men have the highest incidence and mortality from prostate cancer in the world. Multiple reasons have been postulated to explain these findings, although the definitive reasons for them are unknown. While both environmental and genetic factors may contribute to prostate cancer susceptibility, results from multiple studies consistently implicate a strong genetic component to this cancer. However, a specific gene that is consistently and reproducibly associated with prostate cancer risk in any population has not been identified. Association studies examining the frequency of common but specific genetic variants in study populations with and without a particular disease (i.e., case-control) is a powerful way to detect the influence of common genetic variants capable of affecting disease risk. While these types of studies are powerful, they are not without limitations, including the tendency to be confounded due to population stratification (a critical issue in admixed populations like African Americans), and the requirement for large, well-matched, and well-characterized study populations. While there has been extensive use of case control studies to identify genetic risk variants in Caucasian populations, corresponding studies in the African American prostate cancer population have been less extensive, typically being much smaller than their Caucasian counterparts, with little or no effort to address the critical issue of population stratification as a confounder. It is now quite clear that unless cases are well matched to controls in terms of genetic heterogeneity in such studies, spurious associations will and undoubtedly have been observed and reported. In this study, the author uses Ancestry Informative Markers (AIM) to match African American prostate cancer cases and controls for the purposes of performing association studies without confounding by population stratification.
Author:
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ISBN:
Category :
Languages : en
Pages : 0
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African-American (A-A) men have the highest rates of prostate cancer in the world. The incidence of prostate cancer for A-A men is 37% higher than Whites and the death rate for A-A men is three times higher than that of the general population. The purpose of the project was to determine whether lifestyle or ethnicity or the combination of both is a reason for excess mortality from prostate cancer for African-Americans? The project was divided into 2 phases. Phase I involved (1) training a cadre of A-A for epidemiological studies and (2) developing survey instruments for assessment of lifestyle and screening, and risk for prostate cancer among A-A men. Both activities have been done successfully. This was the approved statement of work. Phase II (not part of approved statement of work), is to perform the survey using the new survey instruments, starting with a pilot project of a stratified, randomly selected target A-A population. We strongly believe that the results from the Phase II study will allow us to identify African- Americans who are at risk for prostate cancer and also provide intervention strategies for reducing the risk.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 10
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African American men have the highest incidence and mortality from prostate cancer in the world. Multiple reasons have been postulated to explain these findings although the definitive reasons for this are unknown. While both environmental and genetic factors may contribute to prostate cancer susceptibility, results from multiple studies consistently implicate a strong genetic component of this cancer. However, a specific gene which is consistently and reproducibly associated with prostate cancer risk in any population has not been identified. Association studies examining the frequency of common but specific genetic variants in study populations with and without a particular disease (i.e. case-control) is a powerful way to detect the influence of common genetic variants capable of affecting disease risk. While these types of studies are powerful, they are not without limitations, including the tendency to be confounded due to population stratification (a critical issue in admixed populations like African American), and the requirement for large, well matched, and well characterized study populations. While there has been extensive use of case control studies to identify genetic risk variants in Caucasian populations, corresponding studies in the African American prostate cancer population have been less extensive, typically being much smaller than the Caucasian counterparts, with little or no efforts to address the critical issue of population stratification as a confounder. It is now quite clear that unless cases are well matched to controls in terms of genetic heterogeneity in such studies, spurious associations will and undoubtedly have been observed and reported. In this study we use Ancestry Informative Markers (AIM) to match African American prostate cancer cases and controls for the purposes of performing association studies without confounding by population stratification.
Author: Antoinette Percy-Laurry
Publisher:
ISBN:
Category : African Americans
Languages : en
Pages : 240
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Prostate cancer, the leading non-skin malignant cancer among men, affects black men disproportionately. Black men are typically diagnosed at an earlier age and have a higher rate of aggressive tumors compared to other races. This study investigates the relationship of socioeconomic status on prostate cancer severity and mortality among black men. The purpose of the study is to determine whether prostate cancer risk, the aggressiveness of disease, and mortality differ by socioeconomic status. aTwo datasets were utilized. A total of 715 black men with a prostate cancer diagnosis were studied using individual-level data from the linked Surveillance, Epidemiology, and End Results National, Longitudinal and Mortality Study (SEER NLMS) database. Socioeconomic status was assessed and stage and grade of prostate cancer from the medical histories of study participants were used to determined severity. Descriptive statistics and chi-square (X2) tests were used to assess bivariate relationships. Logistic regressions were used to model the likelihood of receiving a high or low stage and grade. The NLMS general population was the second dataset accessed to obtain a larger sample of prostate cancer mortality cases which were analyzed using Cox proportional hazard regression. There were over 50,000 black men in the study sample. The results of the study showed minor differences in the severity of prostate cancer between black men of low and high socioeconomic status. Education was the only variable that showed some significance for both stage and grade. Within-race differences were found between the socioeconomic status variables and mortality among black men. The lower the socioeconomic status, the greater the risk of mortality compared to those of higher socioeconomic status. While socioeconomic differences among black men did not explain the onset or severity of prostate cancer, it did provide some explanation for the high mortality. Much research is needed to assess other external factors such as access to medical care and prostate health education, discrimination, stress exposures, and social norms that might be related to the severity of and mortality from prostate cancer among black men.
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Languages : en
Pages : 0
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The feasibility of developing a veteran cohort to evaluate factors that influence prostate cancer incidence was assessed. We identified 80,720 eligible veterans without prostate cancer through VA computerized records for six Medical Centers (VAMC) . A lifestyle questionnaire was mailed along with a dietary survey (HFFQ) to 3,000 veterans (500 per site), randomly selected from a file of eligible participants. A phone survey was developed to ascertain reasons for non-response from individuals who didn't participate after two mailing attempts. The response rate overall was 24.4% Response was lower for African-Americans (19.4%) than Whites (29.4%). Veterans were also recruited through a face-to-face approach at one VAMC. Of 121 eligible veterans, 90% agreed to participate and were handed or mailed surveys to return to us. The overall return rate was 42.6%. Response among Whites was higher (60.0%) than African-Americans (32.4%). Most veterans contacted regarding non-response felt the survey asked too many questions. African-American non-responders were more concerned about confidentiality and reported more difficulties understanding questions. Though survey response was not as high as expected, the VA provides a unique arena to establish observational cohorts for assessing the health of African-American and White men.
