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3.
Nutrients ; 11(2)2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30720759

RESUMO

Prostate cancer (PC) is one of the most common cancers in men. The global burden of this disease is rising. Its incidence and mortality rates are higher in African American (AA) men compared to white men and other ethnic groups. The treatment decisions for PC are based exclusively on histological architecture, prostate-specific antigen (PSA) levels, and local disease state. Despite advances in screening for and early detection of PC, a large percentage of men continue to be diagnosed with metastatic disease including about 20% of men affected with a high mortality rate within the African American population. As such, this population group may benefit from edible natural products that are safe with a low cost. Hence, the central goal of this article is to highlight PC disparity associated with nutritional factors and highlight chemo-preventive agents from medicinal plants that are more likely to reduce PC. To reach this central goal, we searched the PubMed Central database and the Google Scholar website for relevant papers. Our search results revealed that there are significant improvements in PC statistics among white men and other ethnic groups. However, its mortality rate remains significantly high among AA men. In addition, there are limited studies that have addressed the benefits of medicinal plants as chemo-preventive agents for PC treatment, especially among AA men. This review paper addresses this knowledge gap by discussing PC disparity associated with nutritional factors and highlighting the biomedical significance of three medicinal plants (curcumin, garlic, and Vernonia amygdalina) that show a great potential to prevent/treat PC, as well as to reduce its incidence/prevalence and mortality, improve survival rate, and reduce PC-related health disparity.


Assuntos
Afro-Americanos/estatística & dados numéricos , Anticarcinógenos/uso terapêutico , Disparidades nos Níveis de Saúde , Fitoterapia/métodos , Neoplasias da Próstata/prevenção & controle , Adulto , Idoso , Curcumina/uso terapêutico , Alho , Humanos , Masculino , Pessoa de Meia-Idade , Plantas Medicinais , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/mortalidade , Vernonia
4.
Nat Commun ; 10(1): 431, 2019 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-30683880

RESUMO

Quantifying the genetic correlation between cancers can provide important insights into the mechanisms driving cancer etiology. Using genome-wide association study summary statistics across six cancer types based on a total of 296,215 cases and 301,319 controls of European ancestry, here we estimate the pair-wise genetic correlations between breast, colorectal, head/neck, lung, ovary and prostate cancer, and between cancers and 38 other diseases. We observed statistically significant genetic correlations between lung and head/neck cancer (rg = 0.57, p = 4.6 × 10-8), breast and ovarian cancer (rg = 0.24, p = 7 × 10-5), breast and lung cancer (rg = 0.18, p =1.5 × 10-6) and breast and colorectal cancer (rg = 0.15, p = 1.1 × 10-4). We also found that multiple cancers are genetically correlated with non-cancer traits including smoking, psychiatric diseases and metabolic characteristics. Functional enrichment analysis revealed a significant excess contribution of conserved and regulatory regions to cancer heritability. Our comprehensive analysis of cross-cancer heritability suggests that solid tumors arising across tissues share in part a common germline genetic basis.


Assuntos
Neoplasias da Mama/genética , Neoplasias Colorretais/genética , Neoplasias de Cabeça e Pescoço/genética , Padrões de Herança , Neoplasias Pulmonares/genética , Neoplasias Ovarianas/genética , Neoplasias da Próstata/genética , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etnologia , Neoplasias da Mama/patologia , Estudos de Casos e Controles , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/etnologia , Neoplasias Colorretais/patologia , Grupo com Ancestrais do Continente Europeu , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/etnologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etnologia , Neoplasias Pulmonares/patologia , Masculino , Transtornos Mentais/etnologia , Transtornos Mentais/genética , Transtornos Mentais/fisiopatologia , Proteínas de Neoplasias/genética , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/etnologia , Neoplasias Ovarianas/patologia , Fenótipo , Polimorfismo de Nucleotídeo Único , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/patologia , Fumar/etnologia , Fumar/genética , Fumar/fisiopatologia
5.
Eur J Cancer Care (Engl) ; 28(2): e12977, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30548713

RESUMO

Access and recruitment barriers may have contributed to the underrepresentation of Black African/Caribbean men and their partners in current psychosocial research related to prostate cancer survivors. Whilst some studies have explored recruitment barriers and facilitators from participants' perspectives, little is known from researchers' point of view. This paper aimed to address this gap in the literature. Recruitment strategies included the following: cancer support groups, researchers' networks, media advertisement, religious organisations, National Health Service hospitals and snowball sampling. Thirty-six eligible participants (men = 25, partners = 11) were recruited into the study. Recruitment barriers comprised of gate-keeping and advertisement issues and the stigma associated with prostate cancer disclosure. Facilitators which aided recruitment included collaborating with National Health Service hospitals, snowball sampling, flexible data collection, building rapport with participants to gain their trust and researcher's attributes. Findings highlight that "hard to reach" Black African/Caribbean populations may be more accessible if researchers adopt flexible but strategic and culturally sensitive recruitment approaches. Such approaches should consider perceptions of stigma associated with prostate cancer within these communities and the influence gatekeepers can have in controlling access to potential participants. Increased engagement with healthcare professionals and gatekeepers could facilitate better access to Black African/Caribbean populations so that their voices can be heard and their specific needs addressed within the healthcare agenda.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Seleção de Pacientes , Neoplasias da Próstata/etnologia , Adolescente , Adulto , Publicidade como Assunto , Afro-Americanos/etnologia , Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Africano/psicologia , Idoso , Revelação , Feminino , Controle de Acesso , Acesso aos Serviços de Saúde , Humanos , Relações Interinstitucionais , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Neoplasias da Próstata/psicologia , Pesquisa Qualitativa , Parceiros Sexuais , Estereotipagem , Índias Ocidentais/etnologia , Adulto Jovem
7.
Medicine (Baltimore) ; 97(40): e12504, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30290605

RESUMO

BACKGROUND: Recently, the prognostic value of the platelet-to-lymphocyte ratio (PLR) has been identified in multiple cancers. However, the prognostic significance of the PLR in prostate cancer (PCa) remains conflicting. We therefore searched relevant studies and conducted a meta-analysis. METHODS: Papers from the databases of PubMed, Web of Science, and the Cochrane Library were retrieved. Six studies comprising 1324 patients were included. RESULTS: The pooled analysis demonstrated that an elevated PLR predicted poor overall survival (OS; HR = 1.85, 95% CI = 1.51-2.25, P < .001) and disease-free survival (DFS; HR = 1.4, 95% CI = 1.1-1.79, P = .007). Subgroup analyses showed that the PLR remained a significant prognostic factor for OS irrespective of ethnicity, tumor stage, or cut-off value. The PLR was an indicator of poor DFS in Asian patients, but not in Caucasian patients. No significant publication bias was detected. CONCLUSION: This meta-analysis showed that a high PLR was correlated with poor DFS and OS in patients with prostate cancer. Due to this meta-analysis being derived from a few studies, the results should be validated in clinical practice.


Assuntos
Plaquetas , Linfócitos , Neoplasias da Próstata/sangue , Neoplasias da Próstata/mortalidade , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Intervalo Livre de Doença , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Prognóstico , Neoplasias da Próstata/etnologia
8.
Cancer Causes Control ; 29(10): 895-899, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30099628

RESUMO

PURPOSE: Racial disparities are apparent in the management and outcomes for prostate cancer; however, disparities in compliance to quality measures for radiation therapy for prostate cancer have not been previously studied. Therefore, the goal of the study was to characterize disparities in the compliance rates with quality measures. METHODS: The comparative effectiveness analysis of radiation therapy and surgery study is a population-based, prospective cohort study that enrolled 3708 men with clinically localized prostate cancer from 2011 to 2012. Compliance with 5 radiation-specific quality measures endorsed by national consortia as of 2011 was assessed, and compliance was compared by race using logistic regression. RESULTS: Overall, 604 men received definitive external beam radiation therapy (EBRT) of which 20% were self-reported black, 74% non-Hispanic white, and 6% Hispanic. Less than two-thirds of black and Hispanic men received EBRT that was compliant with all available quality measures (p = 0.012). Compared to white men, black men were less likely to receive dose-escalated EBRT (95% vs. 87%, p = 0.011) and less likely to avoid unnecessary pelvic radiation for low-risk disease (99% vs. 20%, p < 0.001). Compared to white men, Hispanic men were less likely to undergo image guidance (87% vs. 71%, p = 0.04). Black and Hispanic men were more likely to receive EBRT from low-quality providers than white men. CONCLUSIONS: Addressing disparities in access to providers that meet quality guidelines, and improving adherence to evidence-based processes of care may decrease racial/ethnic disparities in prostate cancer outcomes.


Assuntos
Grupos de Populações Continentais , Disparidades em Assistência à Saúde/etnologia , Neoplasias da Próstata/radioterapia , Afro-Americanos , Idoso , Grupos Étnicos , Grupo com Ancestrais do Continente Europeu , Hispano-Americanos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias da Próstata/etnologia , Estados Unidos
9.
Dis Markers ; 2018: 1418609, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29750086

RESUMO

Objective: We conducted an update meta-analysis aiming to verify the association between p27-V109G polymorphism and cancer risk, particular for prostate cancer (PCa). Then, we conducted a case-control study of Han Chinese in central China to verify the evidence-based results. Methods: Relevant studies were collected from diverse databases up to March 2017. In addition, a hospital-based (H-B) case-control study enrolling 90 PCa patients and 140 healthy controls was included to verify these evidence-based findings. Genetic risk was calculated by odds ratio (OR) with its corresponding 95% confidence interval (CI). The p27-V109G polymorphism was determined by MassARRAY genotyping method. Results: Finally, twenty-four published studies comprising 9627 cases and 12,102 controls were enrolled for the current meta-analysis. Overall analysis suggested that p27-V109G polymorphism decreased overall cancer risk in allelic contrast, heterozygote, and dominant models. When stratified analysis was conducted by ethnicity, data revealed that p27-V109G polymorphism was associated with a decreased cancer risk in Caucasians. Highlighted in the subgroup analysis by cancer type, we uncovered a significantly decreased risk of PCa in allelic contrast, dominant, homogeneous, and recessive models. However, in the validation case-control study, we failed to uncover a positive association between p27-V109G polymorphism and PCa risk. In addition, negative results were also identified when subgroup analyses were stratified by age, tumor grade, tumor stage, PSA levels, and other measurements. Conclusion: Although evidence-based results suggest that p27-V109G polymorphism plays a protective role in overall cancer risk, particularly for PCa, our case-control study failed to validate any association between this particular polymorphism and PCa risk.


Assuntos
Inibidor de Quinase Dependente de Ciclina p27/genética , Polimorfismo de Nucleotídeo Único , Neoplasias da Próstata/genética , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , Grupo com Ancestrais do Continente Europeu/genética , Humanos , Masculino , Neoplasias da Próstata/etnologia
10.
Int J Mol Sci ; 19(4)2018 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-29690565

RESUMO

Prostate cancer (CaP) is the most commonly diagnosed non-cutaneous cancer and the second leading cause of male cancer deaths in the United States. Among African American (AA) men, CaP is the most prevalent malignancy, with disproportionately higher incidence and mortality rates. Even after discounting the influence of socioeconomic factors, the effect of molecular and genetic factors on racial disparity of CaP is evident. Earlier studies on the molecular basis for CaP disparity have focused on the influence of heritable mutations and single-nucleotide polymorphisms (SNPs). Most CaP susceptibility alleles identified based on genome-wide association studies (GWAS) were common, low-penetrance variants. Germline CaP-associated mutations that are highly penetrant, such as those found in HOXB13 and BRCA2, are usually rare. More recently, genomic studies enabled by Next-Gen Sequencing (NGS) technologies have focused on the identification of somatic mutations that contribute to CaP tumorigenesis. These studies confirmed the high prevalence of ERG gene fusions and PTEN deletions among Caucasian Americans and identified novel somatic alterations in SPOP and FOXA1 genes in early stages of CaP. Individuals with African ancestry and other minorities are often underrepresented in these large-scale genomic studies, which are performed primarily using tumors from men of European ancestry. The insufficient number of specimens from AA men and other minority populations, together with the heterogeneity in the molecular etiology of CaP across populations, challenge the generalizability of findings from these projects. Efforts to close this gap by sequencing larger numbers of tumor specimens from more diverse populations, although still at an early stage, have discovered distinct genomic alterations. These research findings can have a direct impact on the diagnosis of CaP, the stratification of patients for treatment, and can help to address the disparity in incidence and mortality of CaP. This review examines the progress of understanding in CaP genetics and genomics and highlight the need to increase the representation from minority populations.


Assuntos
Genômica/métodos , Neoplasias da Próstata/genética , Afro-Americanos , Grupo com Ancestrais do Continente Europeu , Estudo de Associação Genômica Ampla , Humanos , Masculino , Polimorfismo de Nucleotídeo Único/genética , Neoplasias da Próstata/etnologia
11.
Cancer Sci ; 109(6): 1920-1929, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29624800

RESUMO

Non-inferiority in the cumulative castration rate of the 3-month formulation of degarelix compared with the 3-month formulation of goserelin was evaluated in subjects with prostate cancer. A phase III, open-label, parallel-arm study was carried out. An initial dose of 240 mg degarelix or 3.6 mg goserelin was given s.c.; after day 28, a maintenance dose of 480 mg degarelix or 10.8 mg goserelin was given once every 84 days. Non-inferiority in castration rate and safety of degarelix to goserelin were evaluated. The primary end-point was the cumulative castration rate from day 28 to day 364 and the non-inferiority margin was set to be 10%. A total of 234 subjects with prostate cancer were randomized to the degarelix group (n = 117) and the goserelin group (n = 117). The cumulative castration rate was 95.1% in the degarelix group and 100.0% in the goserelin group. As there were no events in the goserelin group, an additional analysis was carried out using 95% confidence intervals of the difference in the proportion of subjects with castration. Analyses indicated the non-inferiority of the 3-month formulation of degarelix to goserelin. Degarelix showed more rapid decreases in testosterone, luteinizing hormone, follicle stimulating hormone, and prostate-specific antigen levels compared with goserelin. The most common adverse events in the degarelix group were injection site reactions. Non-inferiority of the 3-month formulation of degarelix to goserelin was shown for testosterone suppression. The 3-month formulation of degarelix was also found to be tolerated as an androgen deprivation therapy for patients with prostate cancer. This trial was registered with ClinicalTrials.gov (identifier NCT01964170).


Assuntos
Gosserrelina/uso terapêutico , Oligopeptídeos/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Idoso , Antineoplásicos Hormonais/administração & dosagem , Antineoplásicos Hormonais/efeitos adversos , Antineoplásicos Hormonais/uso terapêutico , Grupo com Ancestrais do Continente Asiático , Constipação Intestinal/induzido quimicamente , Relação Dose-Resposta a Droga , Esquema de Medicação , Gosserrelina/administração & dosagem , Gosserrelina/efeitos adversos , Humanos , Japão , Masculino , Nasofaringite/induzido quimicamente , Oligopeptídeos/administração & dosagem , Oligopeptídeos/efeitos adversos , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/etnologia , Testosterona/sangue , Resultado do Tratamento
12.
Int Braz J Urol ; 44(4): 697-703, 2018 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29617073

RESUMO

INTRODUCTION: We compared characteristics of patients undergoing prostate biopsy in a high-risk inner city population before and after the 2012 USPSTF recommendation against PSA based prostate cancer screening to determine its effect on prostate biopsy practices. MATERIALS AND METHODS: This was a retrospective study including patients who received biopsies after an abnormal PSA measurement from October 2008-December 2015. Patients with previously diagnosed prostate cancer were excluded. Chi-square tests of independence, two sample t-tests, Mann-Whitney U tests, and Fisher's exact tests were performed. RESULTS: There were 202 and 208 patients in the pre-USPSTF and post-USPSTF recommendation cohorts, respectively. The post-USPSTF cohort had higher median PSA (7.8 versus 7.1ng/mL, p=0.05), greater proportion of patients who were black (96.6% versus 90.5%, p=0.01), and greater percentage of biopsy cores positive for disease (58% versus 29.5%, p<0.001). Multivariable analysis supported that the increase in PSA was independent of the increase in the proportion of patients who were black. The proportion of patients who were classified as D'Amico intermediate and high-risk disease increased in the post-USPSTF cohort and approached statistical significance (70.1% versus 58.8%, p=0.12). CONCLUSIONS: Our study suggests that the USPSTF recommendations may have led to na increase in pre-biopsy PSA as well as greater volume of disease. Also, a greater proportion of patients were being classified with intermediate or high risk disease. While the clinical significance of these findings is unknown, what the data suggests is somewhat troubling. Future research should further examine these changes in a larger cohort as well as resultant long-term outcomes.


Assuntos
Biópsia Guiada por Imagem/normas , Guias de Prática Clínica como Assunto/normas , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Medição de Risco/métodos , Idoso , Detecção Precoce de Câncer/normas , Hospitais Urbanos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Gradação de Tumores , Neoplasias da Próstata/sangue , Neoplasias da Próstata/etnologia , Padrões de Referência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Estatísticas não Paramétricas
13.
Int Braz J Urol ; 44(3): 500-505, 2018 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29412547

RESUMO

BACKGROUND: The association of prostate cancer antigen 3 (PCA3) polymorphism (SNP, rs544190G>A) with metastatic prostate cancer in European descent has been reported. Our aim of the current study was to re-validate the effect of PCA3 polymorphism on prostate cancer risk in an Eastern Chinese population and then estimate possible genetic discrepancies among population. MATERIALS AND METHODS: Taqman assay was employed to determine genotype of SNP rs544190 in 1015 ethnic Han Chinese patients with prostate cancer and 1032 cancerfree controls. Simultaneously, odds ratios (OR) and 95% confidence intervals (95%CI) for risk relationship were calculated by logistic regression models. RESULTS: The statistically significant relationship between PCA3 rs544190G>A and higher prostate cancer risk was not found. Stratification analysis revealed that there was no remarkable association of rs544190 variant AG/AA genotype with prostate cancer risk in every subgroup, except for patients with Gleason score ≤7(3+4). CONCLUSION: Although the results demonstrated that SNP rs544190 was not involved in prostate cancer risk in Eastern Chinese descent, unlike in European population, these might have clinical implications on prostate cancer heterogeneity around the World. To validate these findings, well-designed studies with different ethnic populations are warranted.


Assuntos
Antígenos de Neoplasias/genética , Grupo com Ancestrais do Continente Asiático/genética , Polimorfismo de Nucleotídeo Único/genética , Neoplasias da Próstata/genética , Medição de Risco/métodos , Idoso , Estudos de Casos e Controles , China , Expressão Gênica , Estudos de Associação Genética , Genótipo , Humanos , Modelos Logísticos , Masculino , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/patologia , Fatores de Risco , Fumar/efeitos adversos
14.
Eur J Cancer ; 91: 107-115, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29413967

RESUMO

BACKGROUND: Genetic and nutritional factors have been linked to the risk of aggressive prostate cancer (PCa). The fatty acid (FA) composition of peri-prostatic adipose tissue (PPAT), which reflects the past FA intake, is potentially involved in PCa progression. We analysed the FA composition of PPAT, in correlation with the ethno-geographical origin of the patients and markers of tumour aggressiveness. METHODS: From a cohort of 1000 men treated for PCa by radical prostatectomy, FA composition of PPAT was analysed in 156 patients (106 Caucasians and 50 African-Caribbeans), 78 with an indolent tumour (ISUP group 1 + pT2 + PSA <10 ng/mL) and 78 with an aggressive tumour (ISUP group 4-5 + pT3). The effect of FA extracted from PPAT on in-vitro migration of PCa cells DU145 was studied in 72 patients, 36 Caucasians, and 36 African-Caribbeans. RESULTS: FA composition differed according to the ethno-geographical origin. Linoleic acid, an essential n-6 FA, was 2-fold higher in African-Caribbeans compared with Caucasian patients, regardless of disease aggressiveness. In African-Caribbeans, the FA profile associated with PCa aggressiveness was characterised by low level of linoleic acid along with high levels of saturates. In Caucasians, a weak and negative association was observed between eicosapentaenoic acid level (an n-3 FA) and disease aggressiveness. In-vitro migration of PCa cells using PPAT from African-Caribbean patients was associated with lower content of linoleic acid. CONCLUSION: These results highlight an important ethno-geographical variation of PPAT, in both their FA content and association with tumour aggressiveness.


Assuntos
Tecido Adiposo/metabolismo , Grupo com Ancestrais do Continente Africano , Movimento Celular , Grupo com Ancestrais do Continente Europeu , Ácidos Graxos/metabolismo , Neoplasias da Próstata/química , Tecido Adiposo/patologia , Idoso , Linhagem Celular Tumoral , Bases de Dados Factuais , Ácido Eicosapentaenoico/metabolismo , França/epidemiologia , Humanos , Ácido Linoleico/metabolismo , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Comunicação Parácrina , Prostatectomia , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Transdução de Sinais , Índias Ocidentais/epidemiologia
15.
Nutrients ; 10(1)2018 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-29300347

RESUMO

Prostate cancer (PCa) is the second most commonly diagnosed cancer in men, accounting for 15% of all cancers in men worldwide. Asian populations consume soy foods as part of a regular diet, which may contribute to the lower PCa incidence observed in these countries. This meta-analysis provides a comprehensive updated analysis that builds on previously published meta-analyses, demonstrating that soy foods and their isoflavones (genistein and daidzein) are associated with a lower risk of prostate carcinogenesis. Thirty articles were included for analysis of the potential impacts of soy food intake, isoflavone intake, and circulating isoflavone levels, on both primary and advanced PCa. Total soy food (p < 0.001), genistein (p = 0.008), daidzein (p = 0.018), and unfermented soy food (p < 0.001) intakes were significantly associated with a reduced risk of PCa. Fermented soy food intake, total isoflavone intake, and circulating isoflavones were not associated with PCa risk. Neither soy food intake nor circulating isoflavones were associated with advanced PCa risk, although very few studies currently exist to examine potential associations. Combined, this evidence from observational studies shows a statistically significant association between soy consumption and decreased PCa risk. Further studies are required to support soy consumption as a prophylactic dietary approach to reduce PCa carcinogenesis.


Assuntos
Anticarcinógenos/administração & dosagem , Dieta , Neoplasias da Próstata/prevenção & controle , Comportamento de Redução do Risco , Alimentos de Soja , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Dieta/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Razão de Chances , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/etnologia , Fatores de Proteção , Fatores de Risco
16.
Cancer Lett ; 414: 153-165, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29154974

RESUMO

Prostate cancer (PCa) is the most commonly diagnosed malignancy in males, and, in the United States, is the second leading cause of cancer-related death for men older than 40 years. There is a higher incidence of PCa for African Americans (AAs) than for European-Americans (EAs). Investigations related to the incidence of PCa-related health disparities for AAs suggest that there are differences in the genetic makeup of these populations. Other differences are environmentally induced (e.g., diet and lifestyle), and the exposures are different. Men who immigrate from Eastern to Western countries have a higher risk of PCa than men in their native countries. However, the number of immigrants developing PCa is still lower than that of men in Western countries, suggesting that genetic factors are involved in the development of PCa. Altered genetic polymorphisms are associated with PCa progression. Androgens and the androgen receptor (AR) are involved in the development and progression of PCa. For populations with diverse racial/ethnic backgrounds, differences in lifestyle, diet, and biology, including genetic mutations/polymorphisms and levels of androgens and AR, are risk factors for PCa. Here, we provide an immuno-biological perspective on PCa in relation to racial/ethnic disparities and identify factors associated with the disproportionate incidence of PCa and its clinical outcomes.


Assuntos
Afro-Americanos/genética , Grupo com Ancestrais do Continente Europeu/genética , Disparidades nos Níveis de Saúde , Polimorfismo Genético , Neoplasias da Próstata/genética , Afro-Americanos/estatística & dados numéricos , Androgênios/metabolismo , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Humanos , Incidência , Masculino , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/metabolismo , Receptores Androgênicos/genética , Fatores de Risco , Estados Unidos/epidemiologia
17.
Diabet Med ; 35(1): 107-111, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29078006

RESUMO

AIM: To examine the associations between prostate cancer, diabetes and race/ethnicity. METHODS: Using administrative data from British Columbia, Canada for the period 1994 to 2012, we identified men aged ≥50 years with and without diabetes. Validated surname algorithms identified men as Chinese, Indian or of other race/ethnicity. Multivariable Cox regression was used to estimate adjusted risks of prostate cancer according to diabetes status and race/ethnicity. RESULTS: Our cohort of 160 566 men had a mean (sd) age of 64.7 (9.4) years and a median of 9 years' follow-up. The incidence rates of prostate cancer among those with and without diabetes were 177.4 (171.7-183.4) and 216.0 (209.7-222.5) per 1000 person-years, respectively. The incidence among Chinese men was 120.9 (109.2-133.1), among Indian men it was 144.1 (122.8-169.0) and in men of other ethnicity it was 204.8 (200.2-209.5). Diabetes was independently associated with a lower risk of prostate cancer (adjusted hazard ratio 0.82, 95% CI 0.78-0.86), as was Chinese (adjusted hazard ratio 0.54, 95% CI 0.46,0.63) and Indian (adjusted hazard ratio 0.66, 95% CI 0.49,0.89) race/ethnicity; however, there was no statistically significant interaction between diabetes status and race/ethnicity (all P>0.1). CONCLUSION: Diabetes and Chinese and Indian race/ethnicity were each independently associated with a lower risk of prostate cancer.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Diabetes Mellitus/epidemiologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Neoplasias da Próstata/etnologia , Idoso , Colúmbia Britânica/epidemiologia , Estudos de Coortes , Grupos Étnicos/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Modelos de Riscos Proporcionais , Neoplasias da Próstata/epidemiologia , Estudos Retrospectivos , Fatores de Risco
18.
Eur J Nucl Med Mol Imaging ; 45(2): 226-234, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29101444

RESUMO

PURPOSE: The incidence of prostate cancer is 60% higher and the mortality rate is two- to three-times greater in black versus white men. We report on differences in 68Ga-PSMA-11 PET/CT imaging findings in 77 black South-African (BSAs) and 18 white South-African (WSAs) treatment-naïve primary prostate carcinoma (PPC) patients. METHODS: 68Ga-PSMA-11 PET/CT imaging findings were compared to histological, biochemical and morphological imaging data. Patients were grouped into three Gleason grade groups (GG), GG 1 (scores 3 + 3 and 3 + 4), GG2 (scores 4 + 3 and 4 + 4) and GG3 (scores 9 and 10), and the PSA difference among the groups was determined. Inter-racial difference in SUVmax of the primary tumor as well as its correlation with serum PSA were also determined. RESULTS: Ninety-three out of 95 PPC where readily identified on 68Ga-PSMA-11 PET/CT imaging. Median PPC SUVmax and serum PSA values proved significantly higher (p = 0.033 and p = 0.003) in GG3 patients (median 16.4 and 180 ng/ml) when compared to GG1 patients (median 9.6 and 25.1 ng/ml) or GG2 patients (median 8.8 and 46.2 ng/ml). SUVmax significantly correlated with serum PSA-values (r = 0.377 (p = 0.0001)). Age, frequency of lymph node involvement and distant metastases, and GGs (p ≥ 0.153) were similar in BSAs and WSAs, both median serum PSA-values as well as SUVmax values proved significantly higher in BSAs when compared to WSAs, respectively, 81.6 ng/ml versus 14.5 ng/ml (p = 0.0001) and 11.9 versus 4.38 (p = 0.004). Moreover, Gleason-score normalized median SUVmax values proved 2.5 times higher in BSAs when compared to WSAs (p = 0.005). CONCLUSION: SUVmax values proved significantly related to GG and to be significantly higher in BSAs when compared to WSAs. Also, SUVmax significantly correlated with serum PSA values, which was significantly higher in BSAs when compared with WSAs.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Ácido Edético/análogos & derivados , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Oligopeptídeos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Transporte Biológico , Ácido Edético/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Oligopeptídeos/metabolismo , Neoplasias da Próstata/etnologia , África do Sul/etnologia
19.
Eur Urol Oncol ; 1(3): 215-222, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-31102624

RESUMO

BACKGROUND: African American (AA) men might be less likely to benefit from certain treatment types for localized prostate cancer (PCa). OBJECTIVE: To test treatment rate differences between AA and Caucasian patients with clinically localized PCa, with and without adjustment for other-cause mortality (OCM). DESIGN, SETTING, AND PARTICIPANTS: Within the Surveillance Epidemiology and End Results (SEER) database (2004-2014), we identified 260 309 (94.0%) Caucasian and 15 534 (6.0%) AA patients with PCa. INTERVENTION: Radical prostatectomy (RP), external beam radiotherapy (EBRT), brachytherapy (BT), combination of BT and EBRT (BT+EBRT), or nonlocal treatment (NLT). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We used multivariable logistic regression to assess treatment rates according to race, with or without adjustment for OCM risk according to D'Amico risk classification. OCM was defined using a multivariable Cox regression model, developed using a 50% random sample and validated using the remaining 50%. RESULTS AND LIMITATIONS: Before OCM adjustment, AA patients were less likely to receive RP regardless of D'Amico risk (odds ratio [OR] 0.54 for low risk [LR], 0.45 for intermediate risk [IR], and 0.43 for high risk [HR]) and were less likely to receive BT if D'Amico intermediate risk (OR 0.84) or high risk (OR 0.89). After OCM risk adjustment, AA men were still less likely to receive BT (OR 0.53 for LR, 0.32 for IR, 0.22 for HR) and EBRT (OR 0.74 for LR, 0.69 for IR, 0.83 for HR), but were no longer less likely to receive RP (OR 2.58 for LR, 3.07 for IR, 2.67 for HR) regardless of their D'Amico risk classification. The Cox model of OCM risk was 74.9% accurate in the validation cohort. CONCLUSIONS: For AA men, rates of treatment for localized PCa depend on OCM risk. Lack of OCM risk adjustment may incorrectly suggest that some treatments are delivered at a lower rate than for Caucasians, and vice versa. PATIENT SUMMARY: Our study critically appraised the validity of reported prostate cancer treatment rates for African American men when adjustment for other-cause mortality was not performed.


Assuntos
Adenocarcinoma , Afro-Americanos/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Mortalidade/etnologia , Neoplasias da Próstata , Adenocarcinoma/etnologia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Idoso , Braquiterapia/métodos , Braquiterapia/estatística & dados numéricos , Causas de Morte , Terapia Combinada/mortalidade , Terapia Combinada/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prostatectomia/métodos , Prostatectomia/estatística & dados numéricos , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Programa de SEER/estatística & dados numéricos , Resultado do Tratamento , Estados Unidos/epidemiologia
20.
Cancer ; 123 Suppl 24: 5160-5177, 2017 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-29205313

RESUMO

BACKGROUND: The 5-year relative survival for prostate cancers diagnosed between 1990 and 1994 in the United States was very high (92%); however, survival in black males was 7% lower compared with white males. The authors updated these findings and examined survival by stage and race. METHODS: The authors used data from the CONCORD-2 study for males (ages 15-99 years) who were diagnosed with prostate cancer in 37 states, covering 80% of the US population. Survival was adjusted for background mortality (net survival) using state-specific and race-specific life tables and was age-standardized. Data were presented for 2001 through 2003 and 2004 through 2009 to account for changes in collecting SEER Summary Stage 2000. RESULTS: Among the 1,527,602 prostate cancers diagnosed between 2001 and 2009, the proportion of localized cases increased from 73% to 77% in black males and from 77% to 79% in white males. Although the proportion of distant-stage cases was higher among black males than among white males, they represented less than 6% of cases in both groups between 2004 and 2009. Net survival exceeded 99% for localized stage between 2004 and 2009 in both racial groups. Overall, and in most states, 5-year net survival exceeded 95%. CONCLUSIONS: Prostate cancer survival has increased since the first CONCORD study, and the racial gap has narrowed. Earlier detection of localized cancers likely contributed to this finding. However, racial disparities also were observed in overall survival. To help understand which factors might contribute to the persistence of this disparity, states could use local data to explore sociodemographic characteristics, such as survivors' health insurance status, health literacy, treatment decision-making processes, and treatment preferences. Cancer 2017;123:5160-77. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.


Assuntos
Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Neoplasias da Próstata/mortalidade , Sistema de Registros , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/patologia , Estados Unidos/epidemiologia , Adulto Jovem
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