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Global Patterns of Prostate Cancer Incidence, Aggressiveness, and Mortality in Men of African Descent

DOI: 10.1155/2013/560857

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Prostate cancer (CaP) is the leading cancer among men of African descent in the USA, Caribbean, and Sub-Saharan Africa (SSA). The estimated number of CaP deaths in SSA during 2008 was more than five times that among African Americans and is expected to double in Africa by 2030. We summarize publicly available CaP data and collected data from the men of African descent and Carcinoma of the Prostate (MADCaP) Consortium and the African Caribbean Cancer Consortium (AC3) to evaluate CaP incidence and mortality in men of African descent worldwide. CaP incidence and mortality are highest in men of African descent in the USA and the Caribbean. Tumor stage and grade were highest in SSA. We report a higher proportion of T1 stage prostate tumors in countries with greater percent gross domestic product spent on health care and physicians per 100,000 persons. We also observed that regions with a higher proportion of advanced tumors reported lower mortality rates. This finding suggests that CaP is underdiagnosed and/or underreported in SSA men. Nonetheless, CaP incidence and mortality represent a significant public health problem in men of African descent around the world. 1. Introduction Little is known about the epidemiology of CaP among men in Sub-Saharan Africa (SSA) [1]. However, men of SSA descent around the world appear to suffer disproportionately from CaP compared to men of other races or ethnicities [2]. The International Agency for Research on Cancer (IARC) estimates that CaP is the leading cancer in terms of incidence and mortality in men from Africa and the Caribbean [3]. IARC also estimates that CaP is a growing problem in Africa with approximately 28,006 deaths from CaP in 2010, and approximately 57,048 deaths in 2030 [4]. This represents a 104% increase in the number of CaP deaths in Africa over the next two decades. However, CaP incidence and mortality rates that may be underestimated in SSA and possibly the Caribbean were compared to USA rates due to lack of screening, limited population-based cancer registry data, and underdiagnosis or treatment. Comparisons of CaP incidence, prevalence, aggressiveness, and mortality in men of SSA descent are limited [5, 6]. Jackson et al. [7] reported that the age-adjusted incidence rate in a combined West African (Accra and Ibadan) series (36.7 per 1000) was almost equal to the rate in the Washington, DC series (40.6 per 1000). Although comparable prevalence data for Senegal are not available, Gueye et al. [8] compared clinical characteristics of CaP in African American (AA) and Senegalese men diagnosed between

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