BACKGROUND: Substantial geographical differences in prostate cancer (PCa) incidence and mortality exist, being lower among Asian (ASI) men compared with Caucasian (CAU) men.
We prospectively compared PCa prevalence in CAU and ASI men from specific populations with low penetrance of prostate-specific antigen screening.
METHODS: Prostate glands were prospectively obtained during autopsy from men who died from causes other than PCa in Moscow, Russia (CAU), and Tokyo, Japan (ASI). Prostates were removed en-block and analyzed in toto. We compared across the 2 populations PCa prevalence, number and Gleason score (GS) of tumour foci, pathological stage, spatial location, and tumor volume using χ2, Mann-Whitney-Wilcoxon tests, and multiple logistic regression. All statistical tests were two-sided.
RESULTS: Three hundred twenty prostates were collected, 220 from CAU men and 100 from ASI mean. The mean age was 62.5 in CAU men and 68.5 years in ASI men (P < .001). PCa prevalences of 37.3% in CAU men and 35.0% in ASI men were observed (P = .70). Average tumor volume was 0.303cm3. In men aged greater than 60 years, PCa was observed in more than 40% of prostates, reaching nearly 60% in men aged greater than 80 years. GS 7 or greater cancers accounted for 23.1% and 51.4% of all PCa in CAU and ASI men, respectively, (P = .003). When adjusted for age and prostate weight, ASI men still had a greater probability of having GS 7 or greater PCa (P = .03).
CONCLUSIONS: PCa is found on autopsy in a similar proportion of Russian and Japanese men. More than 50% of cancers in ASI and nearly 25% of cancers in CAU men have a GS of 7 or greater. Our results suggest that the definition of clinically insignificant PCa might be worth re-examining.
Written by:
Zlotta AR, Egawa S, Pushkar D, Govorov A, Kimura T, Kido M, Takahashi H, Kuk C, Kovylina M, Aldaoud N, Fleshner N, Finelli A, Klotz L, Sykes J, Lockwood G, van der Kwast TH. Are you the author?
Department of Surgery, Division of Urology, Mount Sinai Hospital, Toronto, ON, Canada; Department of Surgical Oncology, Urology and Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Department of Urology, Jikei University School of Medicine, Tokyo, Japan; Department of Urology, University of Moscow, Moscow, Russia; Department of Pathology, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Division of Urology, Sunnybrook and Women's Health Science Centre, Toronto, ON, Canada.
Reference: J Natl Cancer Inst. 2013 Jul 17;105(14):1050-1058.
doi: 10.1093/jnci/djt151
PubMed Abstract
PMID: 23847245
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