Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT).
Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT).
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DOI：
10.1001/jamaoncol.2015.0513
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发表时间：
2015-06
期刊：
影响因子：
28.4
通讯作者：
Kristal AR
中科院分区：
文献类型：
--
作者：
Barrington WE;Schenk JM;Etzioni R;Arnold KB;Neuhouser ML;Thompson IM Jr;Lucia MS;Kristal AR
在美国，非裔美国男性的前列腺癌发病率和死亡率最高。了解这种差异的潜在原因可以确定对非裔美国人男性重要的预防性干预措施。为了确定肥胖与前列腺癌风险的关联在非裔美国人和非西班牙裔白人男性中是否不同，以及肥胖是否改变了与非裔美国人种族相关的额外风险。对3398名非洲裔美国人和22673名非西班牙裔白人男性进行了前瞻性研究，他们参与了硒和维生素E癌症预防试验(2001-2011年)，目前的分析于2014年完成。前列腺癌总发病率，低级别(格里森评分7)和高级别(格里森评分≥7)。在中位数(四分位数范围)为5.6(1.8)年的随访中，非洲裔美国男性的总前列腺癌、低级别前列腺癌和高级别前列腺癌的病例分别为270、148和88例，而非西班牙裔白人男性的相应病例分别为1453、898和441例。尽管体重指数与非西班牙裔白人男性的风险无关，但体重指数与非裔美国男性的风险增加呈正相关(体重指数25与≥35：风险比[HR]，1.49[95%CI，0.95，2.34]；P代表趋势=0.03)。因此，在BMI<25的男性中，与非洲裔美国人种族相关的风险从28%(HR，1.28[95%CI，0.91-1.80])增加到BMI至少35的非洲裔美国男性(HR，2.03[95%CI，1.38-2.98])的103%(HR，2.03[95%CI，1.38-2.98])(趋势=0.03)。在非西班牙裔白人男性中，体重指数与低级别前列腺癌风险呈负相关(BMI；25 vs≥35：HR，0.80[95%CI，0.58-1.09]；趋势P=0.02)，但与非裔美国男性的风险正相关(BMI，<；25 vs≥35：HR，2.22[95%CI，1.17-4.21]；P趋势=0.05)。在非西班牙裔白人男性(BMI，25 vs≥35：HR，1.33[95%CI，0.90-1.97]；P for Trend=.01)和非洲裔美国男性中，体重指数与高级别前列腺癌的风险呈正相关，尽管在非洲裔美国男性中，这种增加可能更大，尽管种族交互作用没有统计学意义(BMI，25 vs≥35：HR，1.81[95%CI，0.79-4.11]；P for Trend=.02)。与非西班牙裔白人男性相比，非洲裔美国人肥胖与前列腺癌风险增加的相关性更强，减少非洲裔美国人男性肥胖可能会减少癌症发病率的种族差异。还需要进一步的研究来阐明非裔美国人和非西班牙裔白人男性肥胖的不同影响的潜在机制。
African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men. To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race. Prospective study of 3398 African American and 22 673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001–2011) with present analyses completed in 2014. Total, low-grade (Gleason score <7), and high-grade (Gleason score ≥7) prostate cancer incidence. With a median (interquartile range) follow-up of 5.6 (1.8) years, there were 270, 148, and 88 cases of total, low-, and high-grade prostate cancers among African American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI, <25 vs ≥35: hazard ratio [HR], 1.49 [95% CI, 0.95, 2.34]; P for trend = .03). Consequently, the risk associated with African American race increased from 28% (HR, 1.28 [95% CI, 0.91–1.80]) among men with BMI less than 25 to 103% (HR, 2.03 [95% CI, 1.38–2.98]) among African American men with BMI at least 35 (P for trend = .03). Body mass index was inversely associated with low-grade prostate cancer risk within non-Hispanic white men (BMI, <25 vs ≥35: HR, 0.80 [95% CI, 0.58–1.09]; P for trend = .02) but positively associated with risk within African American men (BMI, <25 vs ≥35: HR, 2.22 [95% CI, 1.17–4.21]; P for trend = .05). Body mass index was positively associated with risk of high-grade prostate cancer in both non-Hispanic white men (BMI, <25 vs ≥35: HR, 1.33 [95% CI, 0.90–1.97]; P for trend = .01) and African American men, although the increase may be larger within African American men, albeit the racial interaction was not statistically significant (BMI, <25 vs ≥35: HR, 1.81 [95% CI, 0.79–4.11]; P for trend = .02). Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men.