Evaluation of 4,672 routine prostate biopsies performed in six African countries

Jalloh, Mohamed; Friebel, Tara M.; Thiam, F. Sira; Niang, Lamine; Sy, Chang; Siby, Tidiane; Fernandez, P.; Mapulanga, Victor; Maina, Stephen Karuru; Mante, Sunny; Yeboah, Edward D.; Kyei, Mathew Yamoah; Ankomah, R.; Amegbor, Joshua; Adusei, B.; Yegbe, Paul; Watya, Stephen; Kaggwa, Sam; Haiman, Christopher A.; Henderson, Brian E.; Narashimhamurthy, M.; Abuidris, Dafalla Omer; Mohamadani, Ahmed A.; Mohamed, Elgaili; Mansoor, M. O.; Elgaili, EM; Elballal, A.; Zeigler‐Johnson, Charnita; Heyns, Chris F.; Gueye, Serigne; Rebbeck, Timothy R.

doi:10.1007/s12558-013-0264-y

Cited by 10 publications

(9 citation statements)

References 12 publications

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“…The presentation of highly aggressive PCa disease (tumor grade) and elevated serum PSA levels at time of diagnosis within Black men from the most northerly regions of South Africa concurs with previous studies focused on populations from the most southerly region of the country [ 18 , 35 ], which is further compounded when considering clinical presentation for Black men from western countries. We further show that Black men from the rurally located Province of Limpopo are on average 2.6 and 2.9 years older at time of PCa diagnosis than Black men Gauteng and Western Cape, respectively.…”

Section: Discussionsupporting

confidence: 86%

“…Interestingly, a previous study performed in the Western Cape region of South Africa reported the mean age of PCa presentation to be significantly higher in Whites (n = 291; 69.7 years) compared with regionally-matched Blacks (n = 71; 68.9 years) [ 18 ]. The significantly older age at PCa presentation in the SAPCS (71.0 years) may be driven by lack of PSA testing and reflects more closely that reported in Uganda (n = 210; 70.6 years) [ 35 ]. Remarkably, only 3% of the men in the SAPCS presented as a result of a known elevated PSA.…”

Section: Discussionmentioning

confidence: 80%

“…In contrast 35.5% of the SAPCS present with a Gleason score greater than 7, further supported by the observation of poorly differentiated tumors in 26% of the cases. Although Gleason score distribution between African nations is reportedly varied, there is a trend towards a higher percentage of men presenting with a Gleason score greater than 7, specifically 62% Sudan (n = 234), 46% Uganda (n = 197), 31% Botswana (n = 13), 30% Western Cape South Africa (n = 155), and 26% Ghana (n = 440) [ 35 ]. In the same study, the presentation of White South African men with a Gleason score greater than 7 was reportedly 28% (n = 158).…”

Section: Discussionmentioning

confidence: 99%

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Clinical presentation of prostate cancer in Black South Africans

et al. 2014

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BackgroundCompared with White Americans, Black American men are at a significant increased risk of presenting with prostate cancer (PCa) and associated mortality, suggesting a link to African-ancestry. However, PCa status within Africa is largely unknown. We address the clinical presentation of PCa within Black South African men.MethodsOver 1,000 participants with or without PCa have enrolled in the Southern African Prostate Cancer Study (SAPCS). Using genome-wide profiling we establish a unique within Africa population substructure. Adjusting for age, clinical variables were assessed, compared against Black Americans and between rural and urban localities while addressing potential socio-demographic confounders.ResultsWe report a significant difference in the distribution of prostate specific antigen (PSA) levels skewed towards higher PSA levels in the PCa cases (83.0% present with a PSA ≥ 20 µg/L; median PSA = 98.8 µg/L) relative to men with no detectable PCa (18.5% present with a PSA ≥ 20 µg/L; median PSA = 9.1 µg/L). Compared with Black Americans, Black South Africans presented with significantly more aggressive disease defined by Gleason score >7 (17% and 36%, respectively) and PSA ≥ 20 µg/L (17.2% and 83.2%, respectively). We report exasperated disease aggression defined by Gleason score >7 (P = 0.0042) and poorly differentiated tumor grade (P < 0.0001) within rural versus urban localities.ConclusionBlack South African men present with higher PSA levels and histopathological tumor grade compared with Black Americans, which is further escalated in men from rural localities. Our data suggests that lack of PSA testing may be contributing to an aggressive PCa disease phenotype within South African men.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Clinical presentation of prostate cancer in Black South Africans

et al. 2014

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“…Autopsy studies confirm that the highest rates of latent prostate cancer is found in African descent men, with the lowest rates in Asian men 5 . A survey of biopsy-detected prostate cancer in SSA men revealed a high proportion of Gleason 8+ tumors 6 . Despite these consistent observations, variation in access to medical care and extent of cancer registration also vary by geography and confound the ability to make strong inferences about the relationship between race, ethnicity, and geography and prostate cancer aggressiveness based on epidemiological evidence alone.…”

Section: Variation In Prostate Cancer Rates By Race Ethnicity and Gmentioning

confidence: 99%

Prostate Cancer Genetics: Variation by Race, Ethnicity, and Geography

Rebbeck

2017

Seminars in Radiation Oncology

262

189

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Prostate cancer rates vary substantially by race, ethnicity, and geography. These disparities can be explained by variation in access to screening and treatment, variation in exposure to prostate cancer risk factors, and variation in the underlying biology of prostate carcinogenesis (including genomic propensity of some groups to develop biologically aggressive disease). It is clear that access to screening and treatment are critical influencers of prostate cancer rates, yet even among geographically diverse populations with similar access to care (e.g., low and medium income countries), African descent men have higher prostate cancer rates and poorer prognosis. To date, the proportion of prostate cancer that can be explained by environmental exposures is small, and the impact of these factors across different racial, ethnic, or geographical populations is poorly understood. In contrast, prostate cancer has one of the highest heritabilities of all major cancers. Numerous genetic susceptibility markers have been identified from family-based studies, candidate gene association studies, and genome-wide association studies. Some prostate cancer loci, including the risk loci found at chromosome 8q24, have consistent effects in all groups studied to date. However, replication of many susceptibility loci across race, ethnicity, and geography remains limited, and additional studies in certain populations (particularly in men of African descent) are needed to better understand the underlying genetic basis of prostate cancer.

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“…A recent study audited the prostate biopsy practice in centers of sixth SSA countries (Senegal, Ghana, Soudan, Uganda, South Africa, Botswana) [27]. In total 4,672 Black African men underwent prostate biopsy in these centers between 2005 and 2011.…”

Section: Pathology Diagnosis Of Prostate Cancermentioning

confidence: 99%

Prostate Cancer in Sub Saharan Africa

Jalloh¹

2013

J. Nephrol. Urol. Res.

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Prostate cancer is the leading male cancer worldwide. While there are abundant data on the epidemiology, natural history, treatment and outcomes of the disease in the US and many developed countries, prostate cancer is a good example of cancer disparity in that a little is known about the disease in Sub Saharan Africa. Because of the dominant black race in this region and the fact that black men suffer the higher burden of the disease, it is important to understand that cancer in this population. The purpose of this review is to describe the literature of prostate cancer in Sub Saharan Africa. The authors reviewed the published studies on prostate cancer in Sub Saharan Africa available on PubMed. In addition any other accessible study on the topic was included.

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Evaluation of 4,672 routine prostate biopsies performed in six African countries

Cited by 10 publications

References 12 publications

Clinical presentation of prostate cancer in Black South Africans

Clinical presentation of prostate cancer in Black South Africans

Prostate Cancer Genetics: Variation by Race, Ethnicity, and Geography

Prostate Cancer in Sub Saharan Africa

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