PROSTATE CANCER SURVIVAL OF MEN IDENTIFIED AS 'BLACK' BY PLACE OF BIRTH IN THE UNITED STATES: SEER ANALYSIS 1988-2007 Open Access

Abstract

Background: Prostate cancer is one of the most common malignancies in men but
disproportionately affects black men compared to their white counterparts, but these
disparities are also present across different subpopulations of African ancestry. The
disparities associated with prostate cancer are well documented between US whites
and blacks however, no population-based studies have been conducted comparing
prostate cancer survival in US blacks by place of birth.
Methods: Data from the US Surveillance Epidemiology and End Results (SEER)
program were used to compare the clinical and demographic characteristics of
prostate cancer in 23,152 US born, 834 Caribbean born and 379 African born men
diagnosed between 1988 and 2007. Kaplan-Meier curves and multivariate Cox
proportional hazard models were used to assess the effect of place of birth on
prostate cancer survival.
Results: The unadjusted Kaplan-Meier Curves showed that there is a statistically
significant increase in survival among Caribbean and African born cases compared
to their US born counterparts (log-rank = 75,64, P-value = <0.0001). After
controlling for confounders there was a statistically significant increase in survival
for cases born in the Caribbean (HR = 0.68, 95% CI = 0.55, 0.84) and in Africa (HR
= 0.46, 95% CI = 0.28, 0.75) compared to cases born on the US (reference group).
Conclusions: This is the first population-based study that looks at within-race disparities
of prostate cancer in the US including cases born in Africa. Our analyses
demonstrated that survival among African-Americans is lower than that of blacks
born in the Caribbean and Africa and this variation could represent an underlying
difference in genetic, cultural, environmental, and dietary factors.

Table of Contents

Table of Contents

Introduction........................................................................................................................ 1
Methods............................................................................................................................. 3
Results............................................................................................................................... 5
Discussion........................................................................................................................... 7
References.......................................................................................................................... 10
Tables and Figures ............................................................................................................... 12

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Survival Analysis Prostate Cancer Racial Disparities
Committee Chair / Thesis Advisor	Goodman, Michael, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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