Zeigler-Johnson Charnita M, Rennert Hanna, Mittal R Devi, Jalloh Mohamed, Sachdeva Rajeev, Malkowicz S Bruce, Mandhani Anil, Mittal B, Gueye Serigne M, Rebbeck Timothy R
University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Can J Urol. 2008 Jun;15(3):4056-64.
Prostate cancer is common around the world, but rates of advanced disease differ substantially by race and geography. Although a major health issue, little is known about prostate cancer presentation in West Africa and India compared to the United States (US).
The aim of this study was to compare prostate tumor characteristics in four populations of men from the US, Senegal and India.
We recruited prostate cancer patients from four hospital-based populations. The sample included 338 African-Americans, 1265 European-Americans, 122 Asian Indians, and 72 Senegalese. Questionnaire and medical record data were collected on each participant.
We found significant differences in age at diagnosis, BMI, and PSA levels across the groups. Senegalese and Indian men had a higher probability of high stage (T3/T4) disease compared to US men. Gleason grade was significantly higher in Asian Indians compared to other populations. African-Americans, Senegalese, and Asian Indians had a significantly higher probability of metastatic disease compared to European Americans. The odds ratios (OR) for metastasis were consistently higher in Asian Indians compared to American cases. As only 19/72 Senegalese were assessed for metastasis, OR could not be determined for metastasis.
These results suggest that there are significant geographical and ethnic differences in the presentation of prostate cancer. Men in developing countries tend to present with advanced disease compared to US men. Identifying risk factors for advanced disease may help to decrease the rate of poor prostate cancer outcomes and associated mortality worldwide.
前列腺癌在全球范围内都很常见，但晚期疾病的发病率在种族和地域上存在显著差异。尽管这是一个重大的健康问题，但与美国相比，西非和印度的前列腺癌表现情况鲜为人知。
本研究旨在比较来自美国、塞内加尔和印度的四组男性人群的前列腺肿瘤特征。
我们从四个以医院为基础的人群中招募前列腺癌患者。样本包括338名非裔美国人、1265名欧裔美国人、122名亚洲印度人以及72名塞内加尔人。收集了每位参与者的问卷和病历数据。
我们发现各组在诊断年龄、体重指数（BMI）和前列腺特异抗原（PSA）水平上存在显著差异。与美国男性相比，塞内加尔和印度男性患高分期（T3/T4）疾病的可能性更高。与其他人群相比，亚洲印度人的 Gleason 分级显著更高。与欧裔美国人相比，非裔美国人、塞内加尔人和亚洲印度人发生转移疾病的可能性显著更高。与美国病例相比，亚洲印度人转移的比值比（OR）始终更高。由于仅对72名塞内加尔人中的19人进行了转移评估，因此无法确定塞内加尔人转移的OR。
这些结果表明，前列腺癌的表现存在显著的地理和种族差异。与美国男性相比，发展中国家的男性往往表现为晚期疾病。确定晚期疾病的风险因素可能有助于降低全球前列腺癌不良结局及相关死亡率。
