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Racial and Ethnic Trends in Prostate Cancer Incidence and Mortality in Philadelphia, PA: an Observational Study

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Abstract

Background

To learn more about local prostate cancer (PCa) disparities, we conducted descriptive analyses of the role of race and age in PCa using the Pennsylvania Cancer Registry data for Philadelphia (2005–2014).

Methods

We focused on the most prevalent race/ethnic groups: white (33%), black (44%), and Hispanic (9%). Outcomes included PCa rates, tumor stage, and tumor grade. Percent change was used to describe changes in age-adjusted incidence and mortality rates. Frequency tables and logistic regression models were used to describe trends in proportions of advanced PCa by race and time. Race-by-time interaction terms were retained in the models if statistically significant.

Results

PCa incidence was highest for black men over time. Incidence rates declined over time for all race groups (− 28% for white men to − 38% for Hispanic men). PCa mortality rates declined in a less universal manner (− 5% for blacks to − 32% for whites). Each year, odds increased across all race groups for advanced tumor stage (4% each year among white and Hispanic men and 9% each year among black men) and for advanced tumor grade (4% each year among white and black men and 23% each year among Hispanic men). Among younger men, black men experienced significantly increased odds of advanced tumor stage each year (8%) and Hispanics experienced significantly increased odds of advanced tumor grade each year (30%).

Conclusions

Black men remain at highest PCa risk relative to other racial/ethnic groups in Philadelphia. Younger black and Hispanic men are at particular risk for advanced PCa at diagnosis.

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Abbreviations

PCa:

Prostate cancer

USPSTF:

United States Preventive Services Task Force

EDDIE:

Enterprise Data Dissemination Informatics Exchange

PSA:

Prostate specific antigen

RAIRs:

Risk-adjusted incidence rates

References

  1. Howlader N, Noone A, Krapcho M, Garshell J, Miller D, Altekruse S, et al. SEER cancer statistics review, 1975–2011. Besthesda: National Cancer Institute; 2014.

    Google Scholar 

  2. SEER. SEER cancer statistics factsheets: prostate cancer. Bethesda: National Cancer Institute; 2016.

    Google Scholar 

  3. Rebbeck TR, Haas GP. Temporal trends and racial disparities in global prostate cancer prevalence. Can J Urol. 2014;21:7496–506.

    PubMed  PubMed Central  Google Scholar 

  4. Tyson MD II, Castle EP. Racial disparities in survival for patients with clinically localized prostate cancer adjusted for treatment effects. Mayo Clin Proc. 2014;89:300–7.

    Article  PubMed  Google Scholar 

  5. Bibbins-Domingo K, Grossman DC, Curry SJ. The US Preventive Services Task Force 2017 draft recommendation statement on screening for prostate cancer: an invitation to review and comment. JAMA. 2017;317:1949–50.

    Article  PubMed  Google Scholar 

  6. Li J, German R, King J, Joseph D, Thompson T, Wu XC, et al. Recent trends in prostate cancer testing and incidence among men under age of 50. Cancer Epidemiol. 2012;36:122–7.

    Article  CAS  PubMed  Google Scholar 

  7. Smith RA, Manassaram-Baptiste D, Brooks D, Doroshenk M, Fedewa S, Saslow D, et al. Cancer screening in the United States, 2015: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2015;65:30–54.

    Article  PubMed  Google Scholar 

  8. Zeigler-Johnson CM, Tierney A, Rebbeck TR, Rundle A. Prostate cancer severity associations with neighborhood deprivation. Prostate Cancer. 2011;2011:846263.

    Article  PubMed  PubMed Central  Google Scholar 

  9. PA_Prostate_Cancer_Task_Force (2017) Prostate cancer recommendations for improving the health of Pennsylvania men.

  10. The_PEW_Cheritable_Trusts (2011) A city transformed—the racial and ethnic changes in Philadelphia over the last 20 years.

  11. PA_Department_of_Health (2017) Enterprise data dissemination informatics exchange.

  12. Lee DJ, Mallin K, Graves AJ, Chang SS, Penson DF, Resnick MJ, et al. Recent changes in prostate cancer screening practices and epidemiology. In: J Urol, vol. 198; 2017. p. 1230–40.

  13. Houston KA, King J, Li J, Jemal A (2018) Trends in prostate cancer incidence rates and prevalence of prostate-specific antigen screening by socioeconomic status and regions in the US, 2004–2013. J Urol. 199:676–682.

  14. Aizer AA, Wilhite TJ, Chen MH, Graham PL, Choueiri TK, Hoffman KE, et al. Lack of reduction in racial disparities in cancer-specific mortality over a 20-year period. Cancer. 2014;120:1532–9.

    Article  PubMed  Google Scholar 

  15. Li C, Ekwueme DU. Years of potential life lost caused by prostate cancer deaths in the United States—projection from 2004 through 2050. Cancer Epidemiol. 2010;34:368–72.

    Article  PubMed  Google Scholar 

  16. Cremers RG, Karim-Kos HE, Houterman S, Verhoeven RH, Schroder FH, van der Kwast TH, et al. Prostate cancer: trends in incidence, survival and mortality in the Netherlands, 1989-2006. Eur J Cancer. 2010;46:2077–87.

    Article  CAS  PubMed  Google Scholar 

  17. Vis AN, Roemeling S, Reedijk AM, Otto SJ, Schroder FH. Overall survival in the intervention arm of a randomized controlled screening trial for prostate cancer compared with a clinically diagnosed cohort. Eur Urol. 2008;53:91–8.

    Article  PubMed  Google Scholar 

  18. Bowen DJ, Hannon PA, Harris JR, Martin DP. Prostate cancer screening and informed decision-making: provider and patient perspectives. Prostate Cancer Prostatic Dis. 2011;14:155–61.

    Article  CAS  PubMed  Google Scholar 

  19. Loeb S. Guideline of guidelines: prostate cancer screening. BJU Int. 2014;114:323–5.

    PubMed  Google Scholar 

  20. Chornokur G, Dalton K, Borysova M, Kumar N. Disparities at presentation, diagnosis, treatment, and survival in African American men affected by prostate cancer. Prostate. 2011;71:985–97.

    Article  PubMed  Google Scholar 

  21. Gjertson CK, Albertsen PC. Use and assessment of PSA in prostate cancer. Med Clin N Am. 2011;95:191–200.

    Article  PubMed  Google Scholar 

  22. Stephenson AJ, Kattan MW, Eastham JA, Bianco FJ Jr, Yossepowitch O, Vickers AJ, et al. Prostate cancer-specific mortality after radical prostatectomy for patients treated in the prostate-specific antigen era. J Clin Oncol. 2009;27:4300–5.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lim LS, Sherin K, Committee APP. Screening for prostate cancer in U.S. men. ACPM position statement on preventive practice. Am J Prev Med. 2008;34:164–70.

    Article  PubMed  Google Scholar 

  24. Powell IJ, Vigneau FD, Bock CH, Ruterbusch J, Heilbrun LK. Reducing prostate cancer racial disparity: evidence for aggressive early prostate cancer PSA testing of African American men. Cancer Epidemiol Biomark Prev. 2014;23:1505–11.

    Article  Google Scholar 

  25. Schroder FH, Hugosson J, Roobol MJ, Tammela TL, Zappa M, Nelen V, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014;384:2027–35.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Banerji JS, Wolff EM, Massman JD 3rd, Odem-Davis K, Porter CR, Corman JM. Prostate needle biopsy outcomes in the era of the U.S. Preventive Services Task Force recommendation against prostate specific antigen based screening. J Urol. 2016;195:66–73.

    Article  PubMed  Google Scholar 

  27. Kavasmaa OT, Tyomkin DB, Mehik A, Parpala TM, Tonttila P, Paananen I, et al. Changing trends in symptomatology, diagnostics, stage and survival of prostate cancer in Northern Finland during a period of 20 years. World J Surg Oncol. 2013;11:258.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Jani AB, Johnstone PA, Liauw SL, Master VA, Brawley OW. Age and grade trends in prostate cancer (1974-2003): a surveillance, epidemiology, and end results registry analysis. Am J Clin Oncol. 2008;31:375–8.

    Article  PubMed  Google Scholar 

  29. Bellizzi KM, Breslau ES, Burness A, Waldron W. Prevalence of cancer screening in older, racially diverse adults: still screening after all these years. Arch Intern Med. 2011;171:2031–7.

    Article  PubMed  Google Scholar 

  30. Public Health Management Corporation (2015) Community Health Database. http://www.phmc.org/site/index.php. Accessed 3 Jan 2017.

  31. Mendhiratta N, Lee T, Prabhu V, Llukani E, Lepor H. 10-year mortality after radical prostatectomy for localized prostate cancer in the prostate-specific antigen screening era. Urology. 2015;86:783–8.

    Article  PubMed  Google Scholar 

  32. Rassweiler J, Rassweiler MC, Kenngott H, Frede T, Michel MS, Alken P, et al. The past, present and future of minimally invasive therapy in urology: a review and speculative outlook. Minim Invasive Ther Allied Technol. 2013;22:200–9.

    Article  PubMed  Google Scholar 

  33. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Hu JC. Use, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery. J Urol. 2012;187:1392–8.

    Article  PubMed  Google Scholar 

  34. Mitchell DL, Tracy CR, Buatti JM, Smith MC, Snow AN, Henry MD, et al. Individualization of adjuvant therapy after radical prostatectomy for clinically localized prostate cancer: current status and future directions. Clin Genitourin Cancer. 2016;14:12–21.

    Article  PubMed  Google Scholar 

  35. Dulaney CR, Osula DO, Yang ES, Rais-Bahrami S. Prostate radiotherapy in the era of advanced imaging and precision medicine. Prostate Cancer. 2016;2016:4897515.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Merrill RM, Sloan A. Risk-adjusted incidence rates for prostate cancer in the United States. Prostate. 2012;72:181–5.

    Article  PubMed  Google Scholar 

  37. Shafique K, Morrison DS. Socio-economic inequalities in survival of patients with prostate cancer: role of age and Gleason grade at diagnosis. PLoS One. 2013;8:e56184.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Aarts MJ, van der Aa MA, Coebergh JW, Louwman WJ. Reduction of socioeconomic inequality in cancer incidence in the south of the Netherlands during 1996-2008. Eur J Cancer. 2010;46:2633–46.

    Article  CAS  PubMed  Google Scholar 

  39. Gonsalves L, Cartmel B, Mueller L. The burden of cancer in Connecticut. Conn Med. 2012;76:335–51.

    PubMed  Google Scholar 

  40. Siegel RL, Fedewa SA, Miller KD, Goding-Sauer A, Pinheiro PS, Martinez-Tyson D, et al. Cancer statistics for Hispanics/Latinos, 2015. CA Cancer J Clin. 2015;65:457–80.

    Article  PubMed  Google Scholar 

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Funding

This study was funded by the Department of Defense (DOD W81XWH-15-1-0693). However, the DOD did not play a role in the study design, analysis, interpretation of results, or writing of the manuscript.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Division of Population Science, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA

    Charnita Zeigler-Johnson & Amy Leader

  2. Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA

    Scott Keith

  3. College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA

    Russell McIntire, Tashika Robinson & Amy Leader

  4. Center for Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA

    Karen Glanz

Authors
  1. Charnita Zeigler-Johnson
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  2. Scott Keith
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  3. Russell McIntire
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  4. Tashika Robinson
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  5. Amy Leader
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  6. Karen Glanz
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Contributions

CZJ acquired data; was responsible for the study concept/design, analysis, and interpretation; and drafted the manuscript. SK assisted with data analysis and interpretation and revised the manuscript. RM revised the manuscript. TR was responsible for the data analysis and revised the manuscript. AL revised the manuscript. KG was responsible for the study concept and revised the manuscript.

Corresponding author

Correspondence to Charnita Zeigler-Johnson.

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Conflict of Interest

The authors declare that they have no conflict interests.

Ethics Approval and Consent to Participate

This observational study based upon Pennsylvania Cancer Registry data was approved by the Institutional Review Board (IRB) at Thomas Jefferson University (Philadelphia, PA). The IRB reference number is 15G.337. Informed consent was waived by the review board.

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Zeigler-Johnson, C., Keith, S., McIntire, R. et al. Racial and Ethnic Trends in Prostate Cancer Incidence and Mortality in Philadelphia, PA: an Observational Study. J. Racial and Ethnic Health Disparities 6, 371–379 (2019). https://doi.org/10.1007/s40615-018-00534-z

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  • DOI: https://doi.org/10.1007/s40615-018-00534-z

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