title: Addressing the contribution of previously described genetic and epidemiological risk factors associated with increased prostate cancer risk and aggressive disease within men from South Africa.
abstract: BACKGROUND
  Although African ancestry represents a significant risk factor for prostate cancer, few studies have investigated the significance of prostate cancer and relevance of previously defined genetic and epidemiological prostate cancer risk factors within Africa. We recently established the Southern African Prostate Cancer Study (SAPCS), a resource for epidemiological and genetic analysis of prostate cancer risk and outcomes in Black men from South Africa. Biased towards highly aggressive prostate cancer disease, this is the first reported data analysis.
  
  
  METHODS
  The SAPCS is an ongoing population-based study of Black men with or without prostate cancer. Pilot analysis was performed for the first 837 participants, 522 cases and 315 controls. We investigate 46 pre-defined prostate cancer risk alleles and up to 24 epidemiological measures including demographic, lifestyle and environmental factors, for power to predict disease status and to drive on-going SAPCS recruitment, sampling procedures and research direction.
  
  
  RESULTS
  Preliminary results suggest that no previously defined risk alleles significantly predict prostate cancer occurrence within the SAPCS. Furthermore, genetic risk profiles did not enhance the predictive power of prostate specific antigen (PSA) testing. Our study supports several lifestyle/environmental factors contributing to prostate cancer risk including a family history of cancer, diabetes, current sexual activity and erectile dysfunction, balding pattern, frequent aspirin usage and high PSA levels.
  
  
  CONCLUSIONS
  Despite a clear increased prostate cancer risk associated with an African ancestry, experimental data is lacking within Africa. This pilot study is therefore a significant contribution to the field. While genetic risk factors (largely European-defined) show no evidence for disease prediction in the SAPCS, several epidemiological factors were associated with prostate cancer status. We call for improved study power by building on the SAPCS resource, further validation of associated factors in independent African-based resources, and genome-wide approaches to define African-specific risk alleles.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Tindall
authors.forename: M S Riana
authors.initials: MS
authors.lastname: Bornman
authors.forename: Smit
authors.initials: S
authors.lastname: van Zyl
authors.forename: Alpheus M
authors.initials: AM
authors.lastname: Segone
authors.forename: L Richard
authors.initials: LR
authors.lastname: Monare
authors.forename: Philip A
authors.initials: PA
authors.lastname: Venter
authors.affiliation: J, Craig Venter Institute, Genomic Medicine Group, San Diego, CA, USA. v.hayes@garvan.org.au.
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: Hayes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D015897:Comorbidity; D005819:Genetic Markers / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000208:ethnology* / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D054526:Men's Health / Q000706:statistics & numerical data; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000208:ethnology* / Q000235:genetics*; D012042:Registries; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology
chemical_list: D005819:Genetic Markers; D017430:Prostate-Specific Antigen