Prostate Cancer Prognostic Factors Among Asian Patients Born in the US Compared to Those Born Abroad

摘要

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. The study included 7,824 Asian 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 (foreign born vs. US born) to three outcomes: prostate specific antigen (PSA) level, Gleason score, and T classification, adjusting for age, marital status, Rural-Urban Continuum Code, and SEER registry. All outcome variables were binary using different cutoffs: a parts per thousand yen4, a parts per thousand yen10 and a parts per thousand yen20 ng/ml for PSA; a parts per thousand yen7 and a parts per thousand yen8 for Gleason score; and a parts per thousand yenT2 and a parts per thousand yenT3 for T classification. Elevated PSA was more common among foreign born Asian men regardless of the cut point used. In the analysis comparing foreign born versus US born patients by ethnic group, the association with PSA was most pronounced at cut point of a parts per thousand yen20 ng/ml for Chinese men (OR 1.68, 95 % CI 1.02-2.75), and at cut point of a parts per thousand yen4 ng/ml for Japanese men (OR 2.73, 95 % CI 1.20-6.21). A statistically significant association with Gleason score was only found for Japanese men and only for the cutoff a parts per thousand yen7 (OR 1.71, 95 % CI 1.12-2.61). There was no difference in clinical T classification between foreign-born and US-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. The data suggest that foreign-born Asian prostate cancer patients may have moderately elevated PSA levels at diagnosis compared with their US born counterparts. For the other prognostic markers, the associations were less consistent and did not form a discernible pattern.