High incidence of prostate cancer metastasis in Afro-Brazilian men with low educational levels: a retrospective observational study

BMC Public Health

Raimundo Fernandes Araújo²  Karina Carla Paula Medeiros²  Carlos Cesar Oliveira Ramos¹  Fábio Aires de Araújo²  Victor Carbone Bernardes Oliveira²  Hugo Gonçalo Guedes²  Alexandre Barbosa Câmara de Souza² 

[1] Doctor Luiz Antonio Hospital, Natal 59040-000, Rio Grande do Norte, Brazil;Department of Morphology, Federal University of Rio Grande do Norte, Natal 59072-970, Rio Grande do Norte, Brazil

关键词: Educational levels;    Risk factor;    Prostate cancer;    Prognosis;    Epidemiology;   

Others  :  1162144
DOI  :  10.1186/1471-2458-13-537

 received in 2012-04-26, accepted in 2013-01-02,  发布年份 2013

【 摘 要 】

Background

This study investigated factors related to ethnicity and educational level, their correlation with tumor stage at the time of diagnosis, and their influence on treatment outcomes in patients with prostate cancer.

Methods

In this retrospective observational study, we analyzed the medical records of 1,349 male patients treated for prostatic adenocarcinoma. We collected information about sociodemographic variables, including educational level and self-reported skin color. We also classified the disease according whether it was to more likely to present with metastasis and measured the tumor response to treatment.

Results

Less-educated (<8 years of education) individuals were 4.8 times more likely to develop metastasis than those with more education (>11 years of education; p < 0.001). Similarly, patients with a self-reported black skin color had a 300% increased risk of metastasis at diagnosis (p = 0.001). Distant metastasis was independently correlated with worse outcomes, such that individuals with distant metastasis were 10 times more likely to die than were those without distant metastasis.

Conclusions

Patients with self-reported black skin color and <8 years of education were more likely to display advanced disease at the time of diagnosis compared with their counterparts. Only the presence of metastasis was independently associated with mortality or progressive disease.

【 授权许可】

   
2013 de Souza et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Guedes HG, de Souza ABC, de Oliveira VCB, Araújo FA, Araújo Júnior RF: Epidemiological profile of prostate cancer around the world. REUOL 2008, 1(4):347-352.
• [2]Brasil: Estimative/2012 - Cancer Incidence in Brazil. Rio de Janeiro: INCA; 2011:122.
• [3]Delongchamps NB, Singh A, Haas GP: Epidemiology of prostate cancer in Africa: another step in the understanding of the disease? Curr Probl Cancer 2007, 31(3):226-236.
• [4]Martin NE, Mucci LA, Loda M, Depinho RA: Prognostic determinants in prostate cancer. Cancer J 2011, 17(6):429-437.
• [5]Platz EA, Leitzmann MF, Michaud DS, Willett WC, Giovannucci E: Interrelation of energy intake, body size, and physical activity with prostate cancer in a large prospective cohort study. Cancer Res 2003, 63(23):8542-8548.
• [6]Leavy J, Ambrosini G, Fritschi L: Vietnam military service history and prostate cancer. BMC Public Health 2006, 6:75.
• [7]Ruzzin J: Public health concern behind the exposure to persistent organic pollutants and the risk of metabolic diseases. BMC Public Health 2012, 12:298.
• [8]Mostaghel EA, Solomon KR, Pelton K, Freeman MR, Montgomery RB: Impact of circulating cholesterol levels on growth and intratumoral androgen concentration of prostate tumors. PLoS One 2012, 7(1):e30062.
• [9]de Lima JG, Nobrega LH, de Souza AB: Body adiposity index indicates only total adiposity, not risk. Obesity (Silver Spring) 2012, 20(6):1140.
• [10]Fowke JH, Motley SS, Concepcion RS, Penson DF, Barocas DA: Obesity, body composition, and prostate cancer. BMC Cancer 2012, 12:23.
• [11]Sarma AV, Jaffe CA, Schottenfeld D, Dunn R, Montie JE, Cooney KA, et al.: Insulin-like growth factor-1, insulin-like growth factor binding protein-3, and body mass index: clinical correlates of prostate volume among Black men. Urology 2002, 59(3):362-367.
• [12]Conde FA, Sarna L, Oka RK, Vredevoe DL, Rettig MB, Aronson WJ: Age, body mass index, and serum prostate-specific antigen correlate with bone loss in men with prostate cancer not receiving androgen deprivation therapy. Urology 2004, 64(2):335-340.
• [13]Rogers LQ, Courneya KS, Paragi-Gururaja R, Markwell SJ, Imeokparia R: Lifestyle behaviors, obesity, and perceived health among men with and without a diagnosis of prostate cancer: a population-based, cross-sectional study. BMC Public Health 2008, 8:23.
• [14]Migowski A, Silva GA: Survival and prognostic factors of patients with clinically localized prostate cancer. Rev Saude Publica 2010, 44(2):344-352.
• [15]Gleason DF, Mellinger GT: Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. 1974. J Urol 2002, 16(2 Pt 2):953-958. discussion 59
• [16]Platz EA, Pollak MN, Leitzmann MF, Stampfer MJ, Willett WC, Giovannucci E: Plasma insulin-like growth factor-1 and binding protein-3 and subsequent risk of prostate cancer in the PSA era. Cancer Causes Control 2005, 16(3):255-262.
• [17]Amorim VM, Barros MB, Cesar CL, Goldbaum M, Carandina L, Alves MC: Factors associated with prostate cancer screening: a population-based study. Cad Saude Publica 2011, 27(2):347-356.
• [18]Belon AP, Barros MB, Marin-Leon L: Mortality among adults: gender and socioeconomic differences in a Brazilian city. BMC Public Health 2012, 12:39.
• [19]Mouw T, Koster A, Wright ME, Blank MM, Moore SC, Hollenbeck A, et al.: Education and risk of cancer in a large cohort of men and women in the United States. PLoS One 2008, 3(11):e3639.
• [20]Ben-Shlomo Y, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F, et al.: The risk of prostate cancer amongst black men in the United Kingdom: the PROCESS cohort study. Eur Urol 2008, 53(1):99-105.
• [21]Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ: Cancer statistics, 2003. CA Cancer J Clin 2003, 53(1):5-26.
• [22]Hoffman RM, Gilliland FD, Eley JW, Harlan LC, Stephenson RA, Stanford JL, et al.: Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study. J Natl Cancer Inst 2001, 93(5):388-395.
• [23]Gapstur SM, Gann PH, Kopp P, Colangelo L, Longcope C, Liu K: Serum androgen concentrations in young men: a longitudinal analysis of associations with age, obesity, and race. The CARDIA male hormone study. Cancer Epidemiol Biomarkers Prev 2002, 11(10 Pt 1):1041-1047.
• [24]Freedland SJ, Isaacs WB: Explaining racial differences in prostate cancer in the United States: sociology or biology? Prostate 2005, 62(3):243-252.