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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)6915-6922
Number of pages8
JournalCancer medicine
Volume8
Issue number16
DOIs
StatePublished - Nov 1 2019
Externally publishedYes

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African Americans
Prostatic Neoplasms
Biopsy
Early Detection of Cancer
Population
North American Indians
Uncertainty
Prostate
Neoplasms
Decision Making
Anxiety
Guidelines

Keywords

  • African American
  • prostate biopsy
  • prostate cancer
  • West African ancestry

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

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. / Grizzle, William E.; Kittles, Rick A.; Rais-Bahrami, Soroush; Shah, Ebony; Adams, George W.; DeGuenther, Mark S.; Kolettis, Peter N.; Nix, Jeffrey W.; Bryant, James E.; Chinsky, Ravi; Kearns, James E.; Dehimer, Kerry; Terrin, Norma; Chang, Hong; Gaston, Sandra M.

In: Cancer medicine, Vol. 8, No. 16, 01.11.2019, p. 6915-6922.

Research output: Contribution to journalArticle

Grizzle, WE, Kittles, RA, Rais-Bahrami, S, Shah, E, Adams, GW, DeGuenther, MS, Kolettis, PN, Nix, JW, Bryant, JE, Chinsky, R, Kearns, JE, Dehimer, K, Terrin, N, Chang, H & Gaston, SM 2019, '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, vol. 8, no. 16, pp. 6915-6922. https://doi.org/10.1002/cam4.2434
Grizzle, William E. ; Kittles, Rick A. ; Rais-Bahrami, Soroush ; Shah, Ebony ; Adams, George W. ; DeGuenther, Mark S. ; Kolettis, Peter N. ; Nix, Jeffrey W. ; Bryant, James E. ; Chinsky, Ravi ; Kearns, James E. ; Dehimer, Kerry ; Terrin, Norma ; Chang, Hong ; Gaston, Sandra M. / 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. In: Cancer medicine. 2019 ; Vol. 8, No. 16. pp. 6915-6922.
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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.",
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AU - Rais-Bahrami, Soroush

AU - Shah, Ebony

AU - Adams, George W.

AU - DeGuenther, Mark S.

AU - Kolettis, Peter N.

AU - Nix, Jeffrey W.

AU - Bryant, James E.

AU - Chinsky, Ravi

AU - Kearns, James E.

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AU - Terrin, Norma

AU - Chang, Hong

AU - Gaston, Sandra M.

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N2 - 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.

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