title: Racial differences in prostate cancer risk remain among US servicemen with equal access to care.
abstract: BACKGROUND
  Prostate cancer is the most common cancer among US men, however, the etiology remains unclear. Yet, one consistency is that black non-Hispanic men are at increased risk for prostate cancer compared to white, non-Hispanic men. The goal of this study was to assess relations between demographic and other potential prostate cancer risk factors in the context of the US military healthcare system, which provides equal access to all US servicemen.
  
  
  METHODS
  Military healthcare and demographic data were used to describe risk factors for prostate cancer in the US military from September 1993 to September 2003. Cox's proportional hazards regression was employed to model the time to prostate cancer hospitalization.
  
  
  RESULTS
  Four hundred eight first prostate cancer hospitalizations were identified among 2,761,559 servicemen. The adjusted rate per 100,000 persons rose from 1.41 to 3.62 for white non-Hispanic men and 1.43 to 6.08 for black non-Hispanic men by the end of the study. The increasing incidence over time for combined race/ethnic groups was similar to trends reported in the Surveillance, Epidemiology, and End Results Program for the US civilian population. No association was observed between occupation and prostate cancer hospitalization. However, black non-Hispanic men were at increased risk compared with white non-Hispanic men (hazard ratio = 2.72, 95% confidence interval: 2.12, 3.49).
  
  
  CONCLUSIONS
  No association was observed between occupation and prostate cancer hospitalization. In this relatively young cohort, black non-Hispanic race/ethnicity was found to be predictive of prostate cancer, and this association existed regardless of access to care and socioeconomic status.
authors.affiliation: Air Force Research Laboratory, Wright-Patterson Air Force Base, Dayton, Ohio 45433, USA. timothy.wells@wpafb.af.mil
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Wells
authors.forename: Anna T
authors.initials: AT
authors.lastname: Bukowinski
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
authors.forename: Besa
authors.initials: B
authors.lastname: Smith
authors.forename: Leslie K
authors.initials: LK
authors.lastname: Dennis
authors.forename: Laura K
authors.initials: LK
authors.lastname: Chu
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Gray
authors.forename: Margaret A K
authors.initials: MA
authors.lastname: Ryan
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008889:Military Personnel; D018579:Patient Selection; D011471:Prostatic Neoplasms / Q000208:ethnology*; D012306:Risk; D012307:Risk Factors; D018426:SEER Program; D014481:United States; D044465:White People