Prostate Cancer Prognostic Factors among Patients Born in the US Compared to Those Born Abroad. Open Access

Xu, Junjun (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/td96k3085?locale=en
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Abstract

Background: 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. We examined differences in the measures of disease severity among US-born and foreign-born Asian prostate cancer patients.

Methods: The study included 105,321 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 to three outcomes: PSA level, Gleason score, and T stage, adjusting for age, marital status, Rural-Urban Continuum Code, and SEER registry. All outcome variables were binary using different cutoffs: >=4 ng/ml, >=10 ng/ml and >=20 ng/ml for PSA; >=7 and >=8 for Gleason score; and >=T2 and >=T3 for clinical stage.

Results: Elevated PSA was more common among foreign born Asian men regardless of the cutoff used. In the analysis 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 (OR=2.73, 95% CI 1.20-6.21) for Japanese men. A statistically significant association with Gleason score was only found among foreign born Japanese men and only for the cutoff >=7 (OR=1.71, 95%CI 1.12-2.61). There was no difference in clinical T stage between US-born and foreign-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.

Conclusions: The data suggest that foreign-born Asian prostate cancer cases may have higher PSA levels at diagnosis than their US born counterparts. For other prognostic markers the associations were less consistent and did no form a discernible pattern.

Table of Contents

INTRODUCTION ---------------------------------------------------------------------- 1

METHODS ----------------------------------------------------------------------------- 4

RESULTS ------------------------------------------------------------------------------ 6

DISCUSSION ------------------------------------------------------------------------- 9

REFERENCE -------------------------------------------------------------------------- 11

TABLES ------------------------------------------------------------------------------- 14

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