Risks of prostate cancer and mortality in the city of Sharjah, United Arab Emirates

Abstract

BackgroundProstatic hyperplasia (BPH) and prostate cancer (PCa) are common age-related diseases in men. According to World Health Organization (WHO), PCa is the second most common cancer among Emirati men. This study aimed to identify the risk factors associated with PCa and mortality in a cohort diagnosed with PCa between 2012 and 2021 in Sharjah, United Arab Emirates (UAE).MethodsThe data collected in this retrospective case-control study included patient demographics and comorbidities, as well as PCa markers such as prostate-specific antigen (PSA), prostate volume, prostate-specific antigen density (PSAD), and Gleason scores. Risk factors for PCa were assessed using multivariate logistic regression analysis, and factors associated with all-cause mortality in PCa patients were evaluated using Cox-proportional hazard analysis.ResultsOf the 192 cases analyzed in this study, 88 were diagnosed with PCa and 104 were diagnosed with BPH. Regarding risk factors for PCa, a higher risk of PCa was associated with age 65 or older (OR=2.76, 95% confidence interval (CI): 1.04-7.30; P=0.038) and serum PSAD greater than 0.1 ng/mL2 (OR=3.48, 95% CI:1.66-7.32; P=0.001), whereas being of UAE nationals (OR=0.40, 95% CI:0.18-0.88; P=0.029) were associated with lower risk of PCa, after adjusting for patient demographics and comorbidities. Moreover, regarding cancer markers, higher serum PSA level (P=0.003) and smaller prostate volume (P=0.028) were associated with a higher risk of PCa, after adjusting with patients’ age and BMI. Additionally, a high-grade Gleason score was associated with an increased risk of all-cause mortality after adjusting for patient’s age and BMI (hazard ratio, aHR= 2.3, 95% CI:1.3-4.1; P= 0.016).ConclusionThis study found that age 65 or older and serum PSAD greater than 0.1 ng/mL2 are risk factors for PCa, while UAE nationality is associated with a lower risk. PSAD may be a better screening marker for PCa compared to traditional markers such as PSA and prostate volume.

The Risk Factors and Screening Uptake for Prostate Cancer: A Scoping Review

“…Family history/ genetics was widely accepted and an undisputed risk factor, with men with a family member with a history of breast cancer or those with gene (HOXB13) identified as more likely to develop prostate cancer [46,47]. Age as a risk for prostate cancer was seen to begin at age 40 [47,62,77,78], and into the fifth, sixth, and seventh decades of life men become more prone to prostate cancer [33,47,49,51,62,72,77,79]. However, Chang [41] identified no significant risk with age and prostate cancer.…”

“…Within this review, the screening and diagnostic process evidence included the following: prostatic antigen test/biomarkers were present in 50 papers [33,[35][36][37][38][39][40] The prostatic-antigen test (PSA) was the most-identified screening tool which involves the use of a blood sample to measure the level of PSA in the body, which helps in the diagnosis of the condition. However, PSA testing has raised some controversy [85] and concerns regarding its limitations [36], the threshold level [77,88] and overdiagnosis and overtreatment [38,59,64,85,[87][88][89].…”