The prevalence of prostate cancer in Brazil is higher in Black men than in White men: systematic review and meta-analysis

Abstract

INTRODUcTIONProstate cancer is the most common form of noncutaneous cancer in men and the second leading cause of male cancer mortality. The incidence of prostate cancer varies according to racial/ethnic differences in several countries (1). The estimated incidence of prosBackground: Black men have a higher incidence of prostate cancer compared with White men in several countries. In Brazil, most studies reported a similar prevalence of prostate cancer between Blacks and Whites as a result of the high race mixture of the population. Objective: To perform a systematic review with meta-analysis of the prevalence of prostate cancer in Black versus White, Brown versus White, and Black versus Brown Brazilian men. Design, Setting, and Participants: This systematic review included cohort, cross sectional and case-control studies comparing the prevalence of prostate cancer between races in Brazil. It was performed using an electronic search of references in bibliographic databases, and dissertations and theses databases from several Brazilian hospitals, universities, and schools of medicine. Meta-analysis was conducted using the RevMan software from the Cochrane Collaboration. To control for potential confounding variables, sensitivity analyses excluding case-control and cross sectional studies were performed. Measurements: The outcomes of interest included the number of participants, prevalence of prostate cancer, and odds ratio of cancer between Black and White men, Brown and White men, and Black and Brown men. Results and Limitations: : Twelve studies approaching the prevalence of prostate cancer in Black or Brown vs. White men in Brazil were identifi ed, totalizing 41388 participants. The prevalence of prostate cancer was 9.6% in Black vs. 5.6% in White men (OR 1.58), 10.1% in Black vs. 6.7% in Brown men (OR 1.43), and 6.7% in Brown vs. 6.6% in White men (OR 1.14). Limitations of this review refl ect the complexity and ambiguity in the defi nition of who is Black and who is not in such an heterogeneous population like the Brazilian people. Conclusions: This systematic review with meta-analysis demonstrates a higher prevalence of prostate cancer in Black men compared to White or Brown Brazilian men. The prevalence of prostate cancer is similar in Brown versus White men.

Controversial predictors of biochemical recurrence after radical prostatectomy: a study from a Latin American (Brazilian) Institution

“…Non--Whites in Brazil includes an intermediate Brown (pardo) category along a white-to-black color continuum, often used as a proxy for mulattos or persons with White and Black admixture (14).…”

“…The prevalence of prostate cancer in Brazil is higher in Black men compared to White men (12)(13)(14)(15). We studied the influence of race in regard to biochemical recurrence after radical prostatectomy.…”

The significance of biological, environmental, and social risk factors for prostate cancer in a cohort study in Brazil

“…Although the risk of prostate cancer in the present study was not signifi cantly increased for black versus white men (adjusted RR 1.56, 95%CI 0.64-3.82), similarly to several other Brazilian studies (8-11), a meta-analysis evaluating the prevalence of prostate cancer in black versus white men in Brazil, including the results of our study, demonstrated that the pooled risk of prostate cancer was signifi cantly increased in blacks (RR 1.55, 95%CI 1.32-1.82), suggesting that race is a signifi cant risk factor for prostate cancer in Brazilian men, and that the individual results of most published studies may have been limited by a low sample, a reduced proportion of black men, or a small rate of prostate cancer in each study group (12).…”

Perfil Epidemiológico Do Homem Com Câncer De Próstata Atendido Em Um Hospital Universitário

“…O predomínio de homens portadores desta doença que se declararam brancos é semelhante a estudos brasileiros que identificaram também o predomínio de homens brancos (11,19) . Contudo, estes dados divergem das estatísticas mundiais, que apontam predominância em indivíduos da raça negra (1,20) . A baixa escolaridade identificada na população pesquisada não chama atenção, pois se trata de indivíduos predominantemente idosos, cujas famílias nas primeiras décadas do século passado, priorizavam a sobrevivência em detrimento da escolarização (12) .…”