种族与偶发性前列腺癌的发病率、特征及死亡率的关联：对两个北美当代队列的分析。

Association of race with incidence, characteristics, and mortality from incidental prostate cancer: Analysis of two North American contemporary cohorts.

作者信息

Finati Marco, Morrison Chase, Stephens Alex, Chiarelli Giuseppe, Cirulli Giuseppe Ottone, Tinsley Shane, Davis Matthew, Sood Akshay, Buffi Nicolò, Lughezzani Giovanni, Salonia Andrea, Briganti Alberto, Montorsi Francesco, Busetto Gian Maria, Bettocchi Carlo, Rogers Craig, Carrieri Giuseppe, Abdollah Firas

机构信息

VUI Center for Outcomes Research, Analysis, and Evaluation, Henry Ford Health, Detroit, Michigan, USA.

Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy.

出版信息

Prostate. 2025 Jan;85(1):82-89. doi: 10.1002/pros.24803. Epub 2024 Oct 28.

DOI:10.1002/pros.24803

PMID:39465565

Abstract

BACKGROUND

Non-Hispanic Black (NHB) men are at higher risk both for incidence and mortality from prostate cancer (PCa) compared to Non-Hispanic White (NHW) men, but these findings arise from biopsy-detected PCa reports. We aimed to compare the incidence, subsequent management and cancer-specific mortality (CSM) of incidental PCa among NHB and NHW men, using two different North American cohorts.

METHODS

The Surveillance, Epidemiology and End-Result (SEER: 2004-2017) and our institutional Henry Ford Health (HFH: 1995-2022) databases were queried to identify men diagnosed with incidental PCa. Cumulative incidence estimates were used to calculate CSM differences between NHB and NHW men. Competing-risk multivariable regression analysis tested the impact of race on CSM, after accounting for all available covariates.

RESULTS

A total of 418 and 6,124 incidental PCa cases were recorded in HFH and SEER database respectively. No pathological differences were observed between NHB and NHW men in both the cohorts, except for prostate-specific antigen (PSA) value at diagnosis, which was higher in NHB men. At 10-years, the CSM rates were 5.5% vs 7.2% in our cohort and 8.6% vs 10.3% in the SEER cohort for NHW and NHB men, respectively (all Gray's test p-value > 0.05). At multivariable, race was not an independent predictor of CSM in our HFH cohort (HR: 1.46, 95% CI: 0.57-3.71, p = 0.6). In the SEER cohort, NHB men were 34% less likely to die from PCa from 1 year to the next (95% CI: 0.49-0.90, p = 0.008), when compared with NHW men.

CONCLUSIONS

In the comparison of incidental PCa findings between NHB and NHW men, both groups had similar pathological characteristic and survival outcomes. These findings are different from the 'conventional' screening-detected PCa and suggest that racial differences have minimal to no adverse effects on PCa-specific mortality after incidental diagnosis.

摘要

背景

与非西班牙裔白人（NHW）男性相比，非西班牙裔黑人（NHB）男性患前列腺癌（PCa）的发病率和死亡率更高，但这些结果来自活检检测出的PCa报告。我们旨在使用两个不同的北美队列，比较NHB和NHW男性中偶然发现的PCa的发病率、后续治疗及癌症特异性死亡率（CSM）。

方法

查询监测、流行病学和最终结果（SEER：2004 - 2017）数据库以及我们机构的亨利·福特健康（HFH：1995 - 2022）数据库，以确定被诊断为偶然发现PCa的男性。累积发病率估计用于计算NHB和NHW男性之间的CSM差异。在考虑所有可用协变量后，竞争风险多变量回归分析测试种族对CSM的影响。

结果

HFH数据库和SEER数据库分别记录了418例和6124例偶然发现的PCa病例。在两个队列中，NHB和NHW男性之间未观察到病理差异，但诊断时的前列腺特异性抗原（PSA）值除外，NHB男性的该值更高。在10年时，我们队列中NHW和NHB男性的CSM率分别为5.5%和7.2%，SEER队列中分别为8.6%和10.3%（所有Gray检验p值>0.05）。在多变量分析中，种族不是我们HFH队列中CSM的独立预测因素（风险比：1.46，95%置信区间：0.57 - 3.71，p = 0.6）。在SEER队列中，与NHW男性相比，NHB男性从1年到下一年死于PCa的可能性降低了34%（95%置信区间：0.49 - 0.90，p = 0.008）。