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Grizzle WE, Kittles RA, Rais-Bahrami S, Shah E, Adams GW, DeGuenther MS, Kolettis PN, Nix JW, Bryant JE, Chinsky R, Kearns JE, Dehimer K, Terrin N, Chang H, Gaston SM. Self-Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy. Cancer Med 2019; 8:6915-6922. [PMID: 31568648 PMCID: PMC6853835 DOI: 10.1002/cam4.2434] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 01/07/2023] Open
Abstract
Concerns about overtreatment of clinically indolent prostate cancer (PrCa) have led to recommendations that men who are diagnosed with low-risk PrCa be managed by active surveillance (AS) rather than immediate definitive treatment. However the risk of underestimating the aggressiveness of a patient's PrCa can be a significant source of anxiety and a barrier to patient acceptance of AS. The uncertainty is particularly keen for African American (AA) men who are about 1.7 times more likely to be diagnosed with PrCa than European American (EA) men and about 2.4 times more likely to die of this disease. The AA population, as many other populations in the Americas, is genetically heterogeneous with varying degrees of admixture from West Africans (WAs), Europeans, and Native Americans (NAs). Recommendations for PrCa screening and management rarely consider potential differences in risk within the AA population. We compared WA genetic ancestry in AA men undergoing standard prostate biopsy who were diagnosed with no cancer, low-grade PrCa (Gleason Sum 6), or higher grade PrCa (Gleason Sum 7-10). We found that WA genetic ancestry was significantly higher in men who were diagnosed with PrCa on biopsy, compared to men who were cancer-negative, and highest in men who were diagnosed with higher grade PrCa (Gleason Sum 7-10). Incorporating WA ancestry into the guidelines for making decisions about when to obtain a biopsy and whether to choose AS may allow AA men to personalize their approach to PrCa screening and management.
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Affiliation(s)
- William E Grizzle
- Department of Pathology and Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rick A Kittles
- Department of Population Sciences, City of Hope, Duarte, CA, USA
| | | | - Ebony Shah
- Department of Population Sciences, City of Hope, Duarte, CA, USA
| | | | | | - Peter N Kolettis
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffrey W Nix
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James E Bryant
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | - Norma Terrin
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hong Chang
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sandra M Gaston
- Tufts Medical Center, Boston, MA, USA.,Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
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McClelland S, Sandler KA, Degnin C, Chen Y, Mitin T. Active Surveillance for Low and Intermediate Risk Prostate Cancer: Opinions of North American Genitourinary Oncology Expert Radiation Oncologists. Clin Genitourin Cancer 2018; 16:e323-e325. [DOI: 10.1016/j.clgc.2017.10.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 10/30/2017] [Indexed: 12/01/2022]
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