title: Prostate cancer characteristics and survival in males of African Ancestry according to place of birth: data from Brooklyn-New York, Guyana, Tobago and Trinidad.
abstract: BACKGROUND
  Prostate cancer mortality rates for African-Americans are much higher than Caucasians and a similar trend is observed for prostate cancer survival. Data on recently immigrated African-descent men are lacking.
  
  
  METHODS
  Using cancer registry data from Brooklyn, NY and two countries in the Caribbean (Guyana and Trinidad and Tobago), survival rates were estimated. We also examined whether Black race or Caribbean birthplace predict prostate cancer survival among males living in the United States (US).
  
  
  RESULTS
  The Caribbean cases were diagnosed at a later age than those in the US (Guyana: 74.5 years, Trinidad and Tobago: 72.4 years, Brooklyn: 65.8 years). Patients in the Caribbean had a worse 5-year survival rate compared to those in the US (41.6% vs. 84.4%) but for immigrant Caribbean-born males living in the US the 5-year survival rate was not significantly different from African-Americans (78.1%, 95% CI: 70.9-83.7% vs. 81.4%, 95% CI: 69.5-89.1%, P = 0.792). The risk of death for Caribbean-born was more than three times higher than US-born men (HR: 3.43, 95% CI: 2.17-5.44, adjusted for ethnicity, stage, and mean age of diagnosis). A mean age of diagnosis >65 years old and stage IV disease, but not ethnicity, were found to be independently associated with the risk of death.
  
  
  CONCLUSIONS
  The survival disadvantage for Caribbean-born patients may be partly due to later diagnosis. Interventions focused on screening, education about the disease and early detection could potentially reduce cancer mortality in this population.
authors.affiliation: SUNY Downstate Medical Center, Brooklyn, New York 11203, USA.
authors.forename: Batsirai
authors.initials: B
authors.lastname: Mutetwa
authors.forename: Emanuela
authors.initials: E
authors.lastname: Taioli
authors.forename: Alison
authors.initials: A
authors.lastname: Attong-Rogers
authors.forename: Penelope
authors.initials: P
authors.lastname: Layne
authors.forename: Veronica
authors.initials: V
authors.lastname: Roach
authors.forename: Camille
authors.initials: C
authors.lastname: Ragin
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D006172:Guyana / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000401:mortality*; D012307:Risk Factors; D014300:Trinidad and Tobago / Q000453:epidemiology