Polednak Anthony P
Connecticut Department of Public Health, Hartford, Connecticut 06134-0308, USA.
Ethn Dis. 2002 Fall;12(4):536-40.
To compare recent temporal trends in the proportion of high-grade (less differentiated, or more "aggressive") prostate cancers for Blacks (African Americans) and Whites. Reports of Black-White differences have generated speculation that genetic factors could be involved.
The study included all 126,889 non-Hispanic White and 20,247 Black patients with prostate cancer diagnosed in 1992-1998 and reported to the US National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program of population-based cancer registries.
Overall and stage-specific Black-White differences in proportion of high-grade cancers were not large and declined over time (especially among elderly patients). By 1998, the adjusted odds ratio for high (vs other known) grade was not statistically significant for Black vs White elderly patients when age and stage at diagnosis were included in a multiple logistic regression model.
These data provide little justification for speculation about a genetic basis for a higher proportion of aggressive prostate cancer among Black patients. Trends in Black-White differences in the frequency of high-grade cancer suggest Black-White differences in trends in prostate cancer screening rates (especially in the elderly), which require further investigation.
比较近期黑人（非裔美国人）与白人中高级别（低分化或更具“侵袭性”）前列腺癌比例的时间趋势。关于黑人和白人差异的报道引发了基因因素可能参与其中的猜测。
该研究纳入了1992年至1998年期间诊断出患有前列腺癌并报告给美国国家癌症研究所基于人群癌症登记处的监测、流行病学和最终结果（SEER）计划的所有126,889名非西班牙裔白人患者和20,247名黑人患者。
总体及特定分期的高级别癌症比例的种族差异不大，且随时间推移而下降（尤其是老年患者）。到1998年，当在多因素逻辑回归模型中纳入诊断时的年龄和分期时，黑人和白人老年患者中高级别（与其他已知级别相比）癌症的调整优势比无统计学意义。
这些数据几乎无法为黑人患者中侵袭性前列腺癌比例较高的基因基础猜测提供依据。高级别癌症频率的种族差异趋势表明前列腺癌筛查率趋势存在种族差异（尤其是在老年人中），这需要进一步研究。
