Prostate cancer risk is three-fold higher among men, aged 50-64, of African descent compared with men of Asian-Indian descent in Trinidad and Tobago.
OBJECTIVE
To test the hypothesis that the screening-detected prevalence of prostate cancer is higher among men of African descent than among men of Asian-Indian descent living in Trinidad & Tobago.


METHODS
Population-based prostate cancer screening study among men aged 50-64.


METHODS
Caribbean islands of Trinidad and Tobago.


METHODS
Tobago, population-based sample of 1196 male residents of African descent; Trinidad, 173 agricultural workers of Asian-Indian descent.


METHODS
Serum prostate specific antigen (PSA, Abbot AxSYM) and digital rectal exam (DRE) were used to screen men for prostate cancer. Men with elevated PSA (> or = 4 ng/mL) and/or abnormal DRE were offered an ultrasound guided sextant biopsy of the prostate gland.


METHODS
Prevalence of abnormal screen; prevalence of prostate cancer.


RESULTS
Elevated PSA and/or abnormal DRE were observed in 29% (348/1196) of Afro-Tobagonian men. Three hundred sixteen men underwent biopsies. Screening-detected prostate cancer prevalence was: 4.9% (23/468) for those aged 50-55; 7.7% (28/366) for those aged 55-59; and 13.3% (48/362) for those aged 60-64 years. Screening was abnormal in 18% (31/173) of Asian-Indian men; 25 underwent biopsies. Prostate cancer prevalence in Asian Indian men was: 1.6% (1/63) for those aged 50-54; 1.4% (1/71) for those aged 55-59; and 5.1% (2/39) for those aged 60-64 years. Mantel-Haenszel age-adjusted rate ratio was 3.4, 95% CI 1.3-9.0.


CONCLUSIONS
This study establishes a high prevalence of screening-detected prostate cancer among Afro-Tobagonians compared with Indo-Trinidadians. Comparison of candidate genes, environmental, and lifestyle factors between these populations may identify factors that increase risk for, or provide protection against, prostate cancer.
Bunker
Clareann H
CH
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. bunkerc@pitt.edu
Patrick
Alan L
AL
Maharaj
Gloria
G
Keenan
Hillary A
HA
Ramnarine
Sham
S
Belle
Andrew
A
Richard
Jean Robert
JR
Dhir
Rajiv
R
D000349:Africa / Q000208:ethnology; D017677:Age Distribution; D001208:Asia / Q000208:ethnology; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D012307:Risk Factors; D014300:Trinidad and Tobago / Q000453:epidemiology
D017430:Prostate-Specific Antigen