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 Medicine

William E. Grizzle¹  Ebony Shah²  Rick A. Kittles²  Norma Terrin³  Hong Chang³  Jeffrey W. Nix⁴  Peter N. Kolettis⁴  James E. Bryant⁴  Soroush Rais‐Bahrami⁴  James E. Kearns⁵  Sandra M. Gaston⁵  Ravi Chinsky⁵  Kerry Dehimer⁵  Mark S. DeGuenther⁶  George W. Adams⁶ 

[1] Department of Pathology and Surgery University of Alabama at Birmingham Birmingham AL USA;Department of Population Sciences City of Hope Duarte CA USA;Department of Radiation Oncology University of Miami Miller School of Medicine Miami FL USA;Department of Urology University of Alabama at Birmingham Birmingham AL USA;Tufts Medical Center Boston MA USA;Urology Centers of Alabama Homewood AL USA;

关键词: African American;    prostate biopsy;    prostate cancer;    West African ancestry;   

DOI  :  10.1002/cam4.2434

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown