Hoffman R M, Gilliland F D, Eley J W, Harlan L C, Stephenson R A, Stanford J L, Albertson P C, Hamilton A S, Hunt W C, Potosky A L
Medicine Service, Department of Veterans Affairs Medical Center, Albuquerque, NM 87108, USA.
J Natl Cancer Inst. 2001 Mar 7;93(5):388-95. doi: 10.1093/jnci/93.5.388.
African-Americans have twice the risk of non-Hispanic whites for presenting with advanced-stage prostate cancer. To investigate the reasons for this difference, we evaluated the association between race/ethnicity and advanced-stage prostate cancer, adjusting for demographic, socioeconomic, clinical, and pathologic factors.
A population-based cohort of 3173 men diagnosed with prostate cancer between October 1, 1994, and October 31, 1995, was analyzed. Medical record abstracts and self-administered survey questionnaires were used to obtain information regarding race/ethnicity, age, marital status, insurance status, educational level, household income, employment status, comorbidity, urinary function, prostate-specific antigen level, tumor grade, and clinical stage. The odds ratio (OR) for advanced-stage prostate cancer was estimated with weighted logistic regression analysis. All P: values were two-sided.
Clinically advanced-stage prostate cancers were detected more frequently in African-Americans (12.3%) and Hispanics (10.5%) than in non-Hispanic whites (6.3%). Socioeconomic, clinical, and pathologic factors each accounted for about 15% of the increased relative risk. After adjusting for all covariates, the risk remained statistically significantly increased for African-Americans (OR = 2.26; 95% confidence interval [CI] = 1.43 to 3.58) but not for Hispanics (OR = 1.23; 95% CI = 0.73 to 2.08).
Traditional socioeconomic, clinical, and pathologic factors accounted for the increased relative risk for presenting with advanced-stage prostate cancer in Hispanic but not in African-American men.
非裔美国人患晚期前列腺癌的风险是非西班牙裔白人的两倍。为了探究这种差异的原因，我们评估了种族/族裔与晚期前列腺癌之间的关联，并对人口统计学、社会经济、临床和病理因素进行了调整。
对1994年10月1日至1995年10月31日期间诊断为前列腺癌的3173名男性进行了基于人群的队列分析。使用病历摘要和自行填写的调查问卷来获取有关种族/族裔、年龄、婚姻状况、保险状况、教育水平、家庭收入、就业状况、合并症、排尿功能、前列腺特异性抗原水平、肿瘤分级和临床分期的信息。通过加权逻辑回归分析估计晚期前列腺癌的优势比（OR）。所有P值均为双侧。
非裔美国人（12.3%）和西班牙裔（10.5%）中临床晚期前列腺癌的检出率高于非西班牙裔白人（6.3%）。社会经济、临床和病理因素各自约占相对风险增加的15%。在对所有协变量进行调整后，非裔美国人的风险仍有统计学显著增加（OR = 2.26；95%置信区间[CI] = 1.43至3.58），但西班牙裔则无（OR = 1.23；95% CI = 0.73至2.08）。
传统的社会经济、临床和病理因素解释了西班牙裔男性患晚期前列腺癌相对风险增加的原因，但不能解释非裔美国男性的情况。
