Clinical presentation of prostate cancer in Black South Africans

BACKGROUND Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African‐ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa...

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Published inThe Prostate Vol. 74; no. 8; pp. 880 - 891
Main Authors Tindall, Elizabeth A., Monare, L. Richard, Petersen, Desiree C., van Zyl, Smit, Hardie, Rae-Anne, Segone, Alpheus M., Venter, Philip A., Bornman, M.S. Riana, Hayes, Vanessa M.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.06.2014
Wiley Subscription Services, Inc
BlackWell Publishing Ltd
Subjects
African Americans - ethnology
African ancestry
African Continental Ancestry Group - ethnology
Aged
Aged, 80 and over
aggressive disease
clinical presentation
Cohort Studies
Follow-Up Studies
Genome-Wide Association Study - methods
Humans
Kallikreins - blood
Kallikreins - genetics
Male
Men
Middle Aged
Original
Prostate cancer
Prostate-Specific Antigen - blood
Prostate-Specific Antigen - genetics
Prostatic Neoplasms - blood
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - ethnology
South Africa - ethnology
Southern Africa
South Africa
African ancestry
aggressive disease
clinical presentation
Prostate cancer
Southern Africa
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Abstract BACKGROUND Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African‐ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa within Black South African men. METHODS Over 1,000 participants with or without PCa have enrolled in the Southern African Prostate Cancer Study (SAPCS). Using genome‐wide profiling we establish a unique within Africa population substructure. Adjusting for age, clinical variables were assessed, compared against Black Americans and between rural and urban localities while addressing potential socio‐demographic confounders. RESULTS We report a significant difference in the distribution of prostate specific antigen (PSA) levels skewed towards higher PSA levels in the PCa cases (83.0% present with a PSA ≥ 20 µg/L; median PSA = 98.8 µg/L) relative to men with no detectable PCa (18.5% present with a PSA ≥ 20 µg/L; median PSA = 9.1 µg/L). Compared with Black Americans, Black South Africans presented with significantly more aggressive disease defined by Gleason score >7 (17% and 36%, respectively) and PSA ≥ 20 µg/L (17.2% and 83.2%, respectively). We report exasperated disease aggression defined by Gleason score >7 (P = 0.0042) and poorly differentiated tumor grade (P < 0.0001) within rural versus urban localities. CONCLUSION Black South African men present with higher PSA levels and histopathological tumor grade compared with Black Americans, which is further escalated in men from rural localities. Our data suggests that lack of PSA testing may be contributing to an aggressive PCa disease phenotype within South African men. Prostate 74:880–891, 2014. © 2014 The Authors. Prostate published by Wiley Periodicals, Inc.
AbstractList Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African-ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa within Black South African men.BACKGROUNDCompared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African-ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa within Black South African men.Over 1,000 participants with or without PCa have enrolled in the Southern African Prostate Cancer Study (SAPCS). Using genome-wide profiling we establish a unique within Africa population substructure. Adjusting for age, clinical variables were assessed, compared against Black Americans and between rural and urban localities while addressing potential socio-demographic confounders.METHODSOver 1,000 participants with or without PCa have enrolled in the Southern African Prostate Cancer Study (SAPCS). Using genome-wide profiling we establish a unique within Africa population substructure. Adjusting for age, clinical variables were assessed, compared against Black Americans and between rural and urban localities while addressing potential socio-demographic confounders.We report a significant difference in the distribution of prostate specific antigen (PSA) levels skewed towards higher PSA levels in the PCa cases (83.0% present with a PSA ≥ 20 µg/L; median PSA = 98.8 µg/L) relative to men with no detectable PCa (18.5% present with a PSA ≥ 20 µg/L; median PSA = 9.1 µg/L). Compared with Black Americans, Black South Africans presented with significantly more aggressive disease defined by Gleason score >7 (17% and 36%, respectively) and PSA ≥ 20 µg/L (17.2% and 83.2%, respectively). We report exasperated disease aggression defined by Gleason score >7 (P = 0.0042) and poorly differentiated tumor grade (P < 0.0001) within rural versus urban localities.RESULTSWe report a significant difference in the distribution of prostate specific antigen (PSA) levels skewed towards higher PSA levels in the PCa cases (83.0% present with a PSA ≥ 20 µg/L; median PSA = 98.8 µg/L) relative to men with no detectable PCa (18.5% present with a PSA ≥ 20 µg/L; median PSA = 9.1 µg/L). Compared with Black Americans, Black South Africans presented with significantly more aggressive disease defined by Gleason score >7 (17% and 36%, respectively) and PSA ≥ 20 µg/L (17.2% and 83.2%, respectively). We report exasperated disease aggression defined by Gleason score >7 (P = 0.0042) and poorly differentiated tumor grade (P < 0.0001) within rural versus urban localities.Black South African men present with higher PSA levels and histopathological tumor grade compared with Black Americans, which is further escalated in men from rural localities. Our data suggests that lack of PSA testing may be contributing to an aggressive PCa disease phenotype within South African men.CONCLUSIONBlack South African men present with higher PSA levels and histopathological tumor grade compared with Black Americans, which is further escalated in men from rural localities. Our data suggests that lack of PSA testing may be contributing to an aggressive PCa disease phenotype within South African men.
BACKGROUND Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African‐ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa within Black South African men. METHODS Over 1,000 participants with or without PCa have enrolled in the Southern African Prostate Cancer Study (SAPCS). Using genome‐wide profiling we establish a unique within Africa population substructure. Adjusting for age, clinical variables were assessed, compared against Black Americans and between rural and urban localities while addressing potential socio‐demographic confounders. RESULTS We report a significant difference in the distribution of prostate specific antigen (PSA) levels skewed towards higher PSA levels in the PCa cases (83.0% present with a PSA ≥ 20 µg/L; median PSA = 98.8 µg/L) relative to men with no detectable PCa (18.5% present with a PSA ≥ 20 µg/L; median PSA = 9.1 µg/L). Compared with Black Americans, Black South Africans presented with significantly more aggressive disease defined by Gleason score >7 (17% and 36%, respectively) and PSA ≥ 20 µg/L (17.2% and 83.2%, respectively). We report exasperated disease aggression defined by Gleason score >7 (P = 0.0042) and poorly differentiated tumor grade (P < 0.0001) within rural versus urban localities. CONCLUSION Black South African men present with higher PSA levels and histopathological tumor grade compared with Black Americans, which is further escalated in men from rural localities. Our data suggests that lack of PSA testing may be contributing to an aggressive PCa disease phenotype within South African men. Prostate 74:880–891, 2014. © 2014 The Authors. Prostate published by Wiley Periodicals, Inc.
Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African-ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa within Black South African men. Over 1,000 participants with or without PCa have enrolled in the Southern African Prostate Cancer Study (SAPCS). Using genome-wide profiling we establish a unique within Africa population substructure. Adjusting for age, clinical variables were assessed, compared against Black Americans and between rural and urban localities while addressing potential socio-demographic confounders. We report a significant difference in the distribution of prostate specific antigen (PSA) levels skewed towards higher PSA levels in the PCa cases (83.0% present with a PSA ≥ 20 µg/L; median PSA = 98.8 µg/L) relative to men with no detectable PCa (18.5% present with a PSA ≥ 20 µg/L; median PSA = 9.1 µg/L). Compared with Black Americans, Black South Africans presented with significantly more aggressive disease defined by Gleason score >7 (17% and 36%, respectively) and PSA ≥ 20 µg/L (17.2% and 83.2%, respectively). We report exasperated disease aggression defined by Gleason score >7 (P = 0.0042) and poorly differentiated tumor grade (P < 0.0001) within rural versus urban localities. Black South African men present with higher PSA levels and histopathological tumor grade compared with Black Americans, which is further escalated in men from rural localities. Our data suggests that lack of PSA testing may be contributing to an aggressive PCa disease phenotype within South African men.
BACKGROUND Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African-ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa within Black South African men. METHODS Over 1,000 participants with or without PCa have enrolled in the Southern African Prostate Cancer Study (SAPCS). Using genome-wide profiling we establish a unique within Africa population substructure. Adjusting for age, clinical variables were assessed, compared against Black Americans and between rural and urban localities while addressing potential socio-demographic confounders. RESULTS We report a significant difference in the distribution of prostate specific antigen (PSA) levels skewed towards higher PSA levels in the PCa cases (83.0% present with a PSA≥20µg/L; median PSA=98.8µg/L) relative to men with no detectable PCa (18.5% present with a PSA≥20µg/L; median PSA=9.1µg/L). Compared with Black Americans, Black South Africans presented with significantly more aggressive disease defined by Gleason score >7 (17% and 36%, respectively) and PSA≥20µg/L (17.2% and 83.2%, respectively). We report exasperated disease aggression defined by Gleason score >7 (P=0.0042) and poorly differentiated tumor grade (P<0.0001) within rural versus urban localities. CONCLUSION Black South African men present with higher PSA levels and histopathological tumor grade compared with Black Americans, which is further escalated in men from rural localities. Our data suggests that lack of PSA testing may be contributing to an aggressive PCa disease phenotype within South African men. Prostate 74:880-891, 2014. © 2014 The Authors. Prostate published by Wiley Periodicals, Inc. [PUBLICATION ABSTRACT]
Author Tindall, Elizabeth A.
Hardie, Rae-Anne
Segone, Alpheus M.
Venter, Philip A.
Bornman, M.S. Riana
van Zyl, Smit
Petersen, Desiree C.
Monare, L. Richard
Hayes, Vanessa M.
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  fullname: Tindall, Elizabeth A.
  organization: J. Craig Venter Institute, California, La Jolla
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  givenname: L. Richard
  surname: Monare
  fullname: Monare, L. Richard
  organization: Department of Urology, University of Limpopo, Medunsa, South Africa
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  organization: J. Craig Venter Institute, La Jolla, California
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  surname: van Zyl
  fullname: van Zyl, Smit
  organization: Department of Urology, University of Limpopo, Medunsa, South Africa
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  givenname: Rae-Anne
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  surname: Venter
  fullname: Venter, Philip A.
  organization: Department of Medical Sciences, University of Limpopo, Turfloop, South Africa
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  surname: Bornman
  fullname: Bornman, M.S. Riana
  organization: Department of Urology, University of Pretoria, Pretoria, South Africa
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  givenname: Vanessa M.
  surname: Hayes
  fullname: Hayes, Vanessa M.
  email: v.hayes@garvan.org.au
  organization: J. Craig Venter Institute, La Jolla, California
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Issue 8
Keywords African ancestry
aggressive disease
clinical presentation
Prostate cancer
Southern Africa
Language English
License Attribution-NonCommercial-NoDerivs
http://creativecommons.org/licenses/by-nc-nd/3.0
2014 The Authors. Prostate published by Wiley Periodicals, Inc.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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Notes National Health and Medical Research Council of Australia
Cancer Institute of New South Wales, Australia
J. Craig Venter Family Fund, CA, U.S.A
Petre Foundation Australia
Medical Research Council (MRC) of South Africa
National Institute of Health (NIH) #CA170081
ArticleID:PROS22806
Unistel Medical Laboratories, South Africa
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content type line 23
Grant sponsor: Medical Research Council (MRC) of South Africa; Grant sponsor: Unistel Medical Laboratories, South Africa; Grant sponsor: Cancer Institute of New South Wales, Australia; Grant sponsor: National Health and Medical Research Council of Australia; Grant sponsor: National Institute of Health (NIH) #CA170081; Grant sponsor: J. Craig Venter Family Fund, CA, U.S.A; Grant sponsor: Petre Foundation Australia.
The authors have no conflicts of interest to disclose.
The present address of Elizabeth A. Tindall is Department of Molecular and Experimental Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037
OpenAccessLink https://proxy.k.utb.cz/login?url=https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fpros.22806
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  text: June 2014
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PublicationTitle The Prostate
PublicationTitleAlternate Prostate
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Chen YC, Page JH, Chen R, Giovannucci E. Family history of prostate and breast cancer and the risk of prostate cancer in the PSA era. Prostate 2008; 68(14):1582-1591.
Diamond J, Bellwood P. Farmers and their languages: The first expansions. Science 2003; 300(5619):597-603.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127(12):2893-2917.
Heyns CF, Fisher M, Lecuona A, van der Merwe A. Prostate cancer among different racial groups in the Western Cape: Presenting features and management. S Afr Med J 2011; 101(4):267-270.
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Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA. Prevalence of prostate cancer among men with a prostate-specific antigen level <or =4.0 ng per milliliter. N Engl J Med 2004; 350(22):2239-2246.
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Hollenbeck BK, Dunn RL, Miller DC, Daignault S, Taub DA, Wei JT. Volume-based referral for cancer surgery: Informing the debate. J Clin Oncol 2007; 25(1):91-96.
Lee J, Demissie K, Lu SE, Rhoads GG. Cancer incidence among Korean-American immigrants in the United States and native Koreans in South Korea. Cancer Control 2007; 14(1):78-85.
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Tindall EA, Bornman MR, van Zyl S, Segone AM, Monare LR, Venter PA, Hayes VM. Addressing the contribution of previously described genetic and epidemiological risk factors associated with increased prostate cancer risk and aggressive disease within men from South Africa. BMC Urol 2013; 13:74.
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Shimizu H, Ross RK, Bernstein L, Yatani R, Henderson BE, Mack TM. Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles County. Br J Cancer 1991; 63(6):963-966.
Henn BM, Gignoux CR, Jobin M, Granka JM, Macpherson JM, Kidd JM, Rodríguez-Botigué L, Ramachandran S, Hon L, Brisbin A, Lin AA, Underhill PA, Comas D, Kidd KK, Norman PJ, Parham P, Bustamante CD, Mountain JL, Feldman MW. Hunter-gatherer genomic diversity suggests a southern African origin for modern humans. Proc Natl Acad Sci USA 2011; 108(13):5154-5162.
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2013; 25
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2010; 127
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References_xml – reference: Henn BM, Cavalli-Sforza LL, Feldman MW. The great human expansion. Proc Natl Acad Sci USA 2012; 109(44):17758-17764.
– reference: Parkin DM, Sitas F, Chirenje M, Stein L, Abratt R, Wabinga H, Part I. Cancer in Indigenous Africans-burden, distribution, and trends. Lancet Oncol 2008; 9(7):683-692.
– reference: Jalloh M, Friebel TM, Sira Thiam F, Niang L, Sy C, Siby T, Fernandez P, Mapulanga V, Maina Doodu S, Mante S, Yeboah E, Kyei M, Ankomah R, Amegbor J, Adusei B, Yegbe P, Watya S, Kaggwa S, Haiman C, Henderson BE, Narashimhamurthy M, Abuidris D, Mohamadani AA, Mohamed E, Mansoor MO, Elgaili EM, Elballal A, Zeigler-Johnson CM, Heyns CF, Gueye SM, Rebbeck TR. Evaluation of 4,672 routine prostate biopsies performed in six African countries. J Afr Cancer 2013; 5(3):144-154.
– reference: Evans S, Metcalfe C, Patel B, Ibrahim F, Anson K, Chinegwundoh F, Corbishley C, Gillatt D, Kirby R, Muir G, Nargund V, Popert R, Wilson P, Persad R, Ben-Shlomo Y. Clinical presentation and initial management of black men and white men with prostate cancer in the United Kingdom: The PROCESS cohort study. Br J Cancer 2010; 102(2):249-254.
– reference: Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127(12):2893-2917.
– reference: Powell IJ, Bock CH, Ruterbusch JJ, Sakr W. Evidence supports a faster growth rate and/or earlier transformation to clinically significant prostate cancer in black than in white American men, and influences racial progression and mortality disparity. J Urol 2010; 183(5):1792-1796.
– reference: Haas GP, Delongchamps N, Brawley OW, Wang CY, de la Roza G. The worldwide epidemiology of prostate cancer: Perspectives from autopsy studies. Can J Urol 2008; 15(1):3866-3871.
– reference: Bigler SA, Pound CR, Zhou X. A retrospective study on pathologic features and racial disparities in prostate cancer. Prostate Cancer 2011; 2011:239460.
– reference: Heyns CF, Fisher M, Lecuona A, van der Merwe A. Prostate cancer among different racial groups in the Western Cape: Presenting features and management. S Afr Med J 2011; 101(4):267-270.
– reference: Peters N, Armstrong K. Racial differences in prostate cancer treatment outcomes: A systematic review. Cancer Nurs 2005; 28(2):108-118.
– reference: Henn BM, Gignoux CR, Jobin M, Granka JM, Macpherson JM, Kidd JM, Rodríguez-Botigué L, Ramachandran S, Hon L, Brisbin A, Lin AA, Underhill PA, Comas D, Kidd KK, Norman PJ, Parham P, Bustamante CD, Mountain JL, Feldman MW. Hunter-gatherer genomic diversity suggests a southern African origin for modern humans. Proc Natl Acad Sci USA 2011; 108(13):5154-5162.
– reference: Chen YC, Page JH, Chen R, Giovannucci E. Family history of prostate and breast cancer and the risk of prostate cancer in the PSA era. Prostate 2008; 68(14):1582-1591.
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– reference: Cnattingius S, Lundberg F, Sandin S, Grönberg H, Iliadou A. Birth characteristics and risk of prostate cancer: The contribution of genetic factors. Cancer Epidemiol Biomarkers Prev 2009; 18(9):2422-2426.
– reference: Wasike RW, Magoha GA. Descriptive case series of patients presenting with cancer of the prostate and their management at Kenyatta National Hospital, Nairobi. East Afr Med J 2007; 84(9 Suppl):S31-S35.
– reference: Thomas JA, Gerber L, Moreira DM, Hamilton RJ, Bañez LL, Castro-Santamaria R, Andriole GL, Isaacs WB, Xu J, Freedland SJ. Prostate cancer risk in men with prostate and breast cancer family history: Results from the REDUCE study (R1). J Intern Med 2012; 272(1):85-92.
– reference: Odedina FT, Akinremi TO, Chinegwundoh F, Roberts R, Yu D, Reams RR, Freedman ML, Rivers B, Green BL, Kumar N. Prostate cancer disparities in Black men of African descent: A comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa. Infect Agent Cancer 2009; 4(Suppl 1):S2.
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– reference: Lee J, Demissie K, Lu SE, Rhoads GG. Cancer incidence among Korean-American immigrants in the United States and native Koreans in South Korea. Cancer Control 2007; 14(1):78-85.
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– reference: Delongchamps NB, Singh A, Haas GP. Epidemiology of prostate cancer in Africa: Another step in the understanding of the disease? Curr Probl Cancer 2007; 31(3):226-236.
– reference: Hollenbeck BK, Dunn RL, Miller DC, Daignault S, Taub DA, Wei JT. Volume-based referral for cancer surgery: Informing the debate. J Clin Oncol 2007; 25(1):91-96.
– reference: Shimizu H, Ross RK, Bernstein L, Yatani R, Henderson BE, Mack TM. Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles County. Br J Cancer 1991; 63(6):963-966.
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– reference: Zakharia F, Basu A, Absher D, Assimes TL, Go AS, Hlatky MA, Iribarren C, Knowles JW, Li J, Narasimhan B, Sidney S, Southwick A, Myers RM, Quertermous T, Risch N, Tang H. Characterizing the admixed African ancestry of African Americans. Genome Biol 2009; 10(12):R141.
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– reference: Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA. Prevalence of prostate cancer among men with a prostate-specific antigen level <or =4.0 ng per milliliter. N Engl J Med 2004; 350(22):2239-2246.
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– reference: Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61(2):69-90.
– reference: Kabore FA, Zango B, Sanou A, Yameogo C, Kirakoya B. Prostate cancer outcome in Burkina Faso. Infect Agent Cancer 2011; 6(Suppl 2):S6.
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Snippet BACKGROUND Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated...
Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality,...
BACKGROUND Compared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated...
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StartPage 880
SubjectTerms African Americans - ethnology
African ancestry
African Continental Ancestry Group - ethnology
Aged
Aged, 80 and over
aggressive disease
clinical presentation
Cohort Studies
Follow-Up Studies
Genome-Wide Association Study - methods
Humans
Kallikreins - blood
Kallikreins - genetics
Male
Men
Middle Aged
Original
Prostate cancer
Prostate-Specific Antigen - blood
Prostate-Specific Antigen - genetics
Prostatic Neoplasms - blood
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - ethnology
South Africa - ethnology
Southern Africa
Title Clinical presentation of prostate cancer in Black South Africans
URI https://api.istex.fr/ark:/67375/WNG-ZPLSBNFC-G/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fpros.22806
https://www.ncbi.nlm.nih.gov/pubmed/24723425
https://www.proquest.com/docview/1518807758
https://www.proquest.com/docview/1519263246
https://pubmed.ncbi.nlm.nih.gov/PMC4135056
Volume 74
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