Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy
Abstract Concerns about overtreatment of clinically indolent prostate cancer (PrCa) have led to recommendations that men who are diagnosed with low‐risk PrCa be managed by active surveillance (AS) rather than immediate definitive treatment. However the risk of underestimating the aggressiveness of a...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-11-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.2434 |
| _version_ | 1827320003749216256 |
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| author | William E. Grizzle Rick A. Kittles Soroush Rais‐Bahrami Ebony Shah George W. Adams Mark S. DeGuenther Peter N. Kolettis Jeffrey W. Nix James E. Bryant Ravi Chinsky James E. Kearns Kerry Dehimer Norma Terrin Hong Chang Sandra M. Gaston |
| author_facet | William E. Grizzle Rick A. Kittles Soroush Rais‐Bahrami Ebony Shah George W. Adams Mark S. DeGuenther Peter N. Kolettis Jeffrey W. Nix James E. Bryant Ravi Chinsky James E. Kearns Kerry Dehimer Norma Terrin Hong Chang Sandra M. Gaston |
| author_sort | William E. Grizzle |
| collection | DOAJ |
| description | Abstract Concerns about overtreatment of clinically indolent prostate cancer (PrCa) have led to recommendations that men who are diagnosed with low‐risk PrCa be managed by active surveillance (AS) rather than immediate definitive treatment. However the risk of underestimating the aggressiveness of a patient's PrCa can be a significant source of anxiety and a barrier to patient acceptance of AS. The uncertainty is particularly keen for African American (AA) men who are about 1.7 times more likely to be diagnosed with PrCa than European American (EA) men and about 2.4 times more likely to die of this disease. The AA population, as many other populations in the Americas, is genetically heterogeneous with varying degrees of admixture from West Africans (WAs), Europeans, and Native Americans (NAs). Recommendations for PrCa screening and management rarely consider potential differences in risk within the AA population. We compared WA genetic ancestry in AA men undergoing standard prostate biopsy who were diagnosed with no cancer, low‐grade PrCa (Gleason Sum 6), or higher grade PrCa (Gleason Sum 7‐10). We found that WA genetic ancestry was significantly higher in men who were diagnosed with PrCa on biopsy, compared to men who were cancer‐negative, and highest in men who were diagnosed with higher grade PrCa (Gleason Sum 7‐10). Incorporating WA ancestry into the guidelines for making decisions about when to obtain a biopsy and whether to choose AS may allow AA men to personalize their approach to PrCa screening and management. |
| first_indexed | 2024-04-25T00:37:58Z |
| format | Article |
| id | doaj.art-c60e117a03be407090e9c6fbeb69447e |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-25T00:37:58Z |
| publishDate | 2019-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-c60e117a03be407090e9c6fbeb69447e2024-03-12T14:35:41ZengWileyCancer Medicine2045-76342019-11-018166915692210.1002/cam4.2434Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsyWilliam E. Grizzle0Rick A. Kittles1Soroush Rais‐Bahrami2Ebony Shah3George W. Adams4Mark S. DeGuenther5Peter N. Kolettis6Jeffrey W. Nix7James E. Bryant8Ravi Chinsky9James E. Kearns10Kerry Dehimer11Norma Terrin12Hong Chang13Sandra M. Gaston14Department of Pathology and Surgery University of Alabama at Birmingham Birmingham AL USADepartment of Population Sciences City of Hope Duarte CA USADepartment of Urology University of Alabama at Birmingham Birmingham AL USADepartment of Population Sciences City of Hope Duarte CA USAUrology Centers of Alabama Homewood AL USAUrology Centers of Alabama Homewood AL USADepartment of Urology University of Alabama at Birmingham Birmingham AL USADepartment of Urology University of Alabama at Birmingham Birmingham AL USADepartment of Urology University of Alabama at Birmingham Birmingham AL USATufts Medical Center Boston MA USATufts Medical Center Boston MA USATufts Medical Center Boston MA USADepartment of Radiation Oncology University of Miami Miller School of Medicine Miami FL USADepartment of Radiation Oncology University of Miami Miller School of Medicine Miami FL USATufts Medical Center Boston MA USAAbstract Concerns about overtreatment of clinically indolent prostate cancer (PrCa) have led to recommendations that men who are diagnosed with low‐risk PrCa be managed by active surveillance (AS) rather than immediate definitive treatment. However the risk of underestimating the aggressiveness of a patient's PrCa can be a significant source of anxiety and a barrier to patient acceptance of AS. The uncertainty is particularly keen for African American (AA) men who are about 1.7 times more likely to be diagnosed with PrCa than European American (EA) men and about 2.4 times more likely to die of this disease. The AA population, as many other populations in the Americas, is genetically heterogeneous with varying degrees of admixture from West Africans (WAs), Europeans, and Native Americans (NAs). Recommendations for PrCa screening and management rarely consider potential differences in risk within the AA population. We compared WA genetic ancestry in AA men undergoing standard prostate biopsy who were diagnosed with no cancer, low‐grade PrCa (Gleason Sum 6), or higher grade PrCa (Gleason Sum 7‐10). We found that WA genetic ancestry was significantly higher in men who were diagnosed with PrCa on biopsy, compared to men who were cancer‐negative, and highest in men who were diagnosed with higher grade PrCa (Gleason Sum 7‐10). Incorporating WA ancestry into the guidelines for making decisions about when to obtain a biopsy and whether to choose AS may allow AA men to personalize their approach to PrCa screening and management.https://doi.org/10.1002/cam4.2434African Americanprostate biopsyprostate cancerWest African ancestry |
| spellingShingle | William E. Grizzle Rick A. Kittles Soroush Rais‐Bahrami Ebony Shah George W. Adams Mark S. DeGuenther Peter N. Kolettis Jeffrey W. Nix James E. Bryant Ravi Chinsky James E. Kearns Kerry Dehimer Norma Terrin Hong Chang Sandra M. Gaston Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy Cancer Medicine African American prostate biopsy prostate cancer West African ancestry |
| title | Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy |
| title_full | Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy |
| title_fullStr | Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy |
| title_full_unstemmed | Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy |
| title_short | Self‐Identified African Americans and prostate cancer risk: West African genetic ancestry is associated with prostate cancer diagnosis and with higher Gleason sum on biopsy |
| title_sort | self identified african americans and prostate cancer risk west african genetic ancestry is associated with prostate cancer diagnosis and with higher gleason sum on biopsy |
| topic | African American prostate biopsy prostate cancer West African ancestry |
| url | https://doi.org/10.1002/cam4.2434 |
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