title: Prostate Cancer Prognostic Factors Among Asian Patients Born in the US Compared to Those Born Abroad.
abstract: US surveillance data indicate that incidence of prostate cancer differs by place of birth among Asian men. However, it is less clear if the prognostic factors for prostate cancer also differ by place of birth. The study included 7,824 Asian prostate cancer patients diagnosed between 2004 and 2009 and reported to the Surveillance Epidemiology and End Results (SEER) program. Logistic regression models were used to evaluate the relation of place of birth (foreign born vs. US born) to three outcomes: prostate specific antigen (PSA) level, Gleason score, and T classification, adjusting for age, marital status, Rural-Urban Continuum Code, and SEER registry. All outcome variables were binary using different cutoffs: ≥ 4, ≥ 10 and ≥ 20 ng/ml for PSA; ≥ 7 and ≥ 8 for Gleason score; and ≥ T2 and ≥ T3 for T classification. Elevated PSA was more common among foreign born Asian men regardless of the cut point used. In the analysis comparing foreign born versus US born patients by ethnic group, the association with PSA was most pronounced at cut point of ≥ 20 ng/ml for Chinese men (OR 1.68, 95% CI 1.02-2.75), and at cut point of ≥ 4 ng/ml for Japanese men (OR 2.73, 95% CI 1.20-6.21). A statistically significant association with Gleason score was only found for Japanese men and only for the cutoff ≥ 7 (OR 1.71, 95% CI 1.12-2.61). There was no difference in clinical T classification between foreign-born and US-born Asian men. Inclusion of cases with missing place of birth or restriction of data to those who underwent radical prostatectomy did not substantially change the results. The data suggest that foreign-born Asian prostate cancer patients may have moderately elevated PSA levels at diagnosis compared with their US born counterparts. For the other prognostic markers, the associations were less consistent and did not form a discernible pattern.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.
authors.forename: Junjun
authors.initials: J
authors.lastname: Xu
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.forename: Ahemdin
authors.initials: A
authors.lastname: Jemal
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Fedewa
mesh_terms: D000368:Aged; D001208:Asia / Q000208:ethnology; D001213:Asian; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D006801:Humans; D008297:Male; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*; D018426:SEER Program; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen
references.citation: Public Health Rep. 2004 Mar-Apr;119(2):174-86
references.pmid: 15192905
references.citation: CA Cancer J Clin. 2012 Jan-Feb;62(1):10-29
references.pmid: 22237781
references.citation: Oncol Nurs Forum. 2007 Nov;34(6):1203-9
references.pmid: 18024347
references.citation: J Urol. 1999 Jan;161(1):152-5
references.pmid: 10037388
references.citation: Am J Public Health. 2003 Oct;93(10):1753-9
references.pmid: 14534233
references.citation: J Urol. 2009 Apr;181(4):1622-7; discussion 1627
references.pmid: 19230923
references.citation: CA Cancer J Clin. 2007 Jul-Aug;57(4):190-205
references.pmid: 17626117
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):590-5
references.pmid: 15767335
references.citation: Prostate. 2012 Sep 15;72(13):1389-98
references.pmid: 22228120
references.citation: J Natl Cancer Inst. 2013 Aug 7;105(15):1096-110
references.pmid: 23878350
references.citation: J Natl Cancer Inst. 1995 May 3;87(9):652-61
references.pmid: 7752270
references.citation: J Natl Med Assoc. 2009 Apr;101(4):316-24
references.pmid: 19397221
references.citation: Ethn Dis. 1998 Autumn;8(3):377-84
references.pmid: 9926908
references.citation: Cancer. 2007 Sep 15;110(6):1255-63
references.pmid: 17701951
references.citation: Cancer Causes Control. 2004 Apr;15(3):243-53
references.pmid: 15090719
references.citation: Cancer. 2009 Jun 15;115(12):2755-64
references.pmid: 19434667
references.citation: Cancer. 2006 Jul 1;107(1):184-92
references.pmid: 16721803
references.citation: Int J Cancer. 2010 Dec 15;127(12):2893-917
references.pmid: 21351269
references.citation: Cancer Epidemiol Biomarkers Prev. 2004 May;13(5):753-8
references.pmid: 15159306
references.citation: J Registry Manag. 2011 Autumn;38(3):120-31
references.pmid: 22223054
references.citation: Ethn Health. 2004 Aug;9(3):283-304
references.pmid: 15370001
references.citation: Urology. 2007 Jun;69(6):1095-101
references.pmid: 17572194
references.citation: Eur Urol. 2012 Jun;61(6):1079-92
references.pmid: 22424666
references.citation: N Engl J Med. 1991 Apr 25;324(17):1156-61
references.pmid: 1707140
references.citation: Prev Med. 2001 Dec;33(6):646-52
references.pmid: 11716662