Black-white differences in tumor grade (aggressiveness) at diagnosis of prostate cancer, 1992-1998.
OBJECTIVE
To compare recent temporal trends in the proportion of high-grade (less differentiated, or more "aggressive") prostate cancers for Blacks (African Americans) and Whites. Reports of Black-White differences have generated speculation that genetic factors could be involved.


METHODS
The study included all 126,889 non-Hispanic White and 20,247 Black patients with prostate cancer diagnosed in 1992-1998 and reported to the US National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program of population-based cancer registries.


RESULTS
Overall and stage-specific Black-White differences in proportion of high-grade cancers were not large and declined over time (especially among elderly patients). By 1998, the adjusted odds ratio for high (vs other known) grade was not statistically significant for Black vs White elderly patients when age and stage at diagnosis were included in a multiple logistic regression model.


CONCLUSIONS
These data provide little justification for speculation about a genetic basis for a higher proportion of aggressive prostate cancer among Black patients. Trends in Black-White differences in the frequency of high-grade cancer suggest Black-White differences in trends in prostate cancer screening rates (especially in the elderly), which require further investigation.
Polednak
Anthony P
AP
Connecticut Department of Public Health, Hartford, Connecticut 06134-0308, USA.
D001741:Black or African American; D000368:Aged; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000235:genetics / Q000473:pathology*; D044469:Racial Groups / Q000235:genetics; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D044465:White People