Impact of Race on the Incidence and Prognosis of Variants of Prostate Adenocarcinoma: A 35 Year SEER Analysis
David M Marcus, Peter J Rossi, Ashesh B Jani, Michael Goodman, Adeboye O Osunkoya. Emory University School of Medicine, Atlanta
Background: Racial disparities have been well described in conventional prostatic adenocarcinoma (PCa), however the impact of race on incidence and outcomes of patients with variants of PCa has not been well characterized. We used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the impact of race on the incidence and prognosis of five variants of PCa.
Design: A search was made through the SEER 17 database to identify cases of mucinous PCa, ductal PCa, signet ring cell PCa, neuroendocrine PCa, and adenosquamous PCa from 1973 to 2008. For comparison, we also identified cases of conventional PCa. We calculated age-adjusted incidence rates and overall survival (OS) for each variant. Incidence and survival in African Americans and Caucasians were compared using rate ratios (RRs) and Kaplan Meier analyses respectively, accompanied by tests for significance.
Results: We identified 790,937 cases of conventional PCa, 806 cases of mucinous PCa, 692 cases of ductal PCa, 502 cases of neuroendocrine PCa, 130 cases of signet ring cell PCa, and 27 cases of adenosquamous PCa. Incidence was higher in African Americans compared to Caucasians for mucinous PCa (RR = 1.63, p = 0.004), ductal PCa (RR = 1.49, p = 0.017), and conventional PCa (RR = 1.45, p <0.001). By contrast, incidence of neuroendocrine PCa was lower in African Americans compared to Caucasians (RR = 0.54, p = 0.016). There was no statistically significant difference in the incidence of adenosquamous PCa and signet ring cell PCa. There was a statistically significant difference in OS in mucinous PCa for Caucasians (5 year OS 77.2%, 95% confidence interval [CI] 73.1 - 80.6%) compared to African Americans (5 year OS 64.8%, 95% CI: 54.9 73.1%, p <0.001), and no statistically significant difference in OS was seen in the other variants of PCa.
Conclusions: There are statistically significant differences in incidence and outcomes in some variants of PCa when stratified by race. African Americans have a higher incidence of mucinous PCa and ductal PCa compared to Caucasians. In contrast, African Americans have a lower incidence of neuroendocrine PCa compared to Caucasians. African Americans are associated with lower OS compared to Caucasians with mucinous PCa. Additional epidemiological studies examining variants of PCa in concert with race are needed to elucidate the etiology of these disparities.
Category: Genitourinary (including renal tumors)
Monday, March 19, 2012 1:00 PM
Poster Session II # 191, Monday Afternoon