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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Research Articles

Asian Race and Risk of Prostate Cancer: Results from the REDUCE Study

Adriana C. Vidal, Taofik Oyekunle, Tom Feng, Alexis R. Freedland, Daniel Moreira, Ramiro Castro-Santamaria, Gerald L. Andriole, Stephen J. Freedland and Emma H. Allott
Adriana C. Vidal
1Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Center for Integrated Research on Cancer and Lifestyle, Los Angeles, California.
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  • For correspondence: adriana.vidal@cshs.org
Taofik Oyekunle
2Surgery Section, Durham VA Medical Center, Durham, North Carolina.
3Duke University School of Medicine, Durham, North Carolina.
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Tom Feng
1Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Center for Integrated Research on Cancer and Lifestyle, Los Angeles, California.
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Alexis R. Freedland
4Department of Epidemiology, UCI School of Medicine, University of California at Irvine, Irvine, California.
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Daniel Moreira
5Department of Urology, University of Chicago, Chicago, Illinois.
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Ramiro Castro-Santamaria
6Ohana Biosciences, Cambridge, Massachusetts.
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Gerald L. Andriole
7Washington University School of Medicine in St. Louis, St. Louis, Missouri.
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Stephen J. Freedland
1Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Center for Integrated Research on Cancer and Lifestyle, Los Angeles, California.
2Surgery Section, Durham VA Medical Center, Durham, North Carolina.
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Emma H. Allott
8Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
9Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland.
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  • ORCID record for Emma H. Allott
DOI: 10.1158/1055-9965.EPI-20-0646 Published November 2020
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Abstract

Background: Global prostate cancer incidence rates are lower in Asian men than Caucasian men. Whether this is the result of less screening in Asian men remains to be determined. We examined whether Asian race was associated with prostate cancer diagnosis in the Reduction by Dutasteride of Cancer Events (REDUCE) study.

Methods: REDUCE was a 4-year, multicenter, randomized trial of dutasteride versus placebo for prostate cancer prevention among men who underwent prostate-specific antigen (PSA)-independent biopsies at 2 and 4 years. Eligible men were ages 50 to 75 years, had PSA between 2.5 and 10 ng/mL, and a negative prestudy prostate biopsy. We tested the association between Asian and Caucasian race and prostate cancer diagnosis using logistic regression.

Results: Of 8,122 men in REDUCE, 5,755 (71%) were Caucasian and 105 (1.8%) were Asian. Asians had lower body mass index (24.8 vs. 26.9 kg/m2, P < 0.001), had smaller prostate volume (35.0 vs. 43.5 cc, P < 0.001), and were less likely to have abnormal digital rectal exams (P = 0.048), but were similar in baseline age, PSA, family history of prostate cancer, and smoking status compared with Caucasian men (all P ≥ 0.164). Asian men were equally likely to receive any on-study biopsy compared with Caucasian men (P = 0.634). After adjusting for potential confounders, Asian men were less likely to be diagnosed with prostate cancer during the 4-year study (OR = 0.49; 95% confidence interval, 0.28–0.88; P = 0.016), compared with Caucasian men.

Conclusions: In REDUCE, where all men underwent biopsies largely independent of PSA, Asian race was associated with lower prostate cancer diagnosis.

Impact: These findings suggest that lower prostate cancer risk in Asian men may be due to biological, genetic, and/or lifestyle factors.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2020;29:2165–70

  • Received April 29, 2020.
  • Revision received June 15, 2020.
  • Accepted August 14, 2020.
  • Published first August 20, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 29 (11)
November 2020
Volume 29, Issue 11
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Asian Race and Risk of Prostate Cancer: Results from the REDUCE Study
Adriana C. Vidal, Taofik Oyekunle, Tom Feng, Alexis R. Freedland, Daniel Moreira, Ramiro Castro-Santamaria, Gerald L. Andriole, Stephen J. Freedland and Emma H. Allott
Cancer Epidemiol Biomarkers Prev November 1 2020 (29) (11) 2165-2170; DOI: 10.1158/1055-9965.EPI-20-0646

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Asian Race and Risk of Prostate Cancer: Results from the REDUCE Study
Adriana C. Vidal, Taofik Oyekunle, Tom Feng, Alexis R. Freedland, Daniel Moreira, Ramiro Castro-Santamaria, Gerald L. Andriole, Stephen J. Freedland and Emma H. Allott
Cancer Epidemiol Biomarkers Prev November 1 2020 (29) (11) 2165-2170; DOI: 10.1158/1055-9965.EPI-20-0646
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