Variations in prostate biopsy recommendation and acceptance confound evaluation of risk factors for prostate cancer: Examining race and BMI |
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| Institution: | 1. From the SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;2. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;3. Department of Psychosocial and Community Health, The University of Washington, Seattle, WA, United States;4. Department of Pathology, The University of Colorado Denver School of Medicine, Denver, CO, United States;5. The Cancer Therapy and Research Center, Christus Santa Rosa Medical Center, San Antonio, TX, United States;1. Department of Experimental Medicine, Microbiology Section, University of Study of Campania “Luigi Vanvitelli”, Via De Crecchio, 7, 80138 Naples, Italy;2. Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 1, 80138 Naples, Italy;1. East Tallinn Central Hospital, Oncology Center, Ravi St 18, 10138 Tallinn, Estonia;2. National Institute for Health Development, Department of Epidemiology and Biostatistics, Hiiu St 42, 11619 Tallinn, Estonia;3. West Tallinn Central Hospital, Womens’ Clinic, Paldiski St 68, 10617 Tallinn, Estonia;4. Tartu University Hospital, Haematology and Oncology Clinic, L. Puusepa St 1A, 50406 Tartu, Estonia;1. Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States;2. International Agency for Research on Cancer, Lyon, France;3. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States;4. Institute of Population Health Sciences, National Health Research Institutes, Taiwan;5. Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France;6. Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan;7. Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan;8. Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil;9. Department of Head and Neck, Heliopolis Hospital, São Paulo, Brazil;10. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy;11. Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, United States;12. Division of Head and Neck Surgical Oncology, Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, United States;13. Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy;14. Penn State College of Medicine, Hershey, PA, United States;15. University of Texas M. D. Anderson Cancer Center, Houston, TX, United States;p. Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, United States;q. Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland;r. College of Public Health, University of Iowa, Iowa City, IA, United States;s. Brown University, Providence, RI, United States;t. Fred Hutchinson Cancer Research Center, Seattle, WA, United States;u. Washington State University College of Pharmacy, Spokane, WA, United States;v. University of Heidelberg, Heidelberg, Germany;w. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States;x. Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy;y. Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy;z. Department of Biomedical and Clinical Sciences, University of Milan, Italy;1. Division of Epidemiology, New York University School of Medicine, New York, United States;2. Institute of Public Health, Section of Hygiene, Universita Cattolica del Sacro Cuore, Rome, Italy;3. Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy;4. Department of Head and Neck Surgery, Institute of Clinical Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy;5. Istituto di Clinica Otorinolaringoiatrica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy;6. Cancer Research Centre, Moscow, Russia;7. Escola Nacional de Suade Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil;8. ACCAMARGO Cancer Center, São Paulo, Brazil;9. Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina;10. Nofer Institute of Occupational Medicine, Lodz, Poland;11. Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy;12. National Institute of Health and Medical Research, Inserm U1018, Villejuif, France;13. Institute of Oncology and Radiobiology, Havana, Cuba;14. Universidade Federal de Pelotas, Pelotas, Brazil;15. Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil;P. National Institute of Public Health, Bucharest, Romania;Q. New York Eye and Ear Infirmary, New York, NY, United States;R. Department of Otolaryngology, School of Medicine, New York Medical College, Valhalla, NY, United States;S. The M. Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Dept. of Cancer Epidemiology and Prevention, Warsaw, Poland;T. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany;U. Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany;V. German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany;W. Regional Authority of Public Health in Banska Bystrica, Slovakia;X. National Institute of Environmental Health, Budapest, Hungary;Y. The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States;1. Medical Health Officer, SSRN Hospital, Pamplemousses, Mauritius;2. Faculty of Science, University of Mauritius, Reduit, Mauritius;3. Pathology Department, Victoria Hospital, Mauritius;4. Radiotherapy Department, Victoria Hospital, Mauritius;5. Nuffield Department of Population Health, University of Oxford, UK;6. Central Laboratory, Candos, Victoria Hospital, Mauritius;1. Department of Medical Imaging, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia;2. Discipline of Pharmacology, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, Australia;3. Department of Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia;4. Department of Plastic Surgery, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia;5. Department of Surgery, The University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia;6. South Australian Pathology, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia;7. Department of Pathology, The University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia;8. Cancer Epidemiology and Population Health, University of South Australia, North Terrace, Adelaide, South Australia 5000, Australia;1. Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA;2. Winship Research Informatics, Emory University, Atlanta, GA, USA |
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| Abstract: | BackgroundProstate cancer is ubiquitous in older men; differential screening patterns and variations in biopsy recommendations and acceptance will affect which man is diagnosed and, therefore, evaluation of cancer risk factors. We describe a statistical method to reduce prostate cancer detection bias among African American (n = 3398) and Non-Hispanic White men (n = 22,673) who participated in the Selenium and Vitamin E Cancer Prevention trial (SELECT) and revisit a previously reported association between race, obesity and prostate cancer risk.MethodsFor men with screening values suggesting prostate cancer but in whom biopsy was not performed, the Prostate Cancer Prevention Trial Risk Calculator was used to estimate probability of prostate cancer. Associations of body mass index (BMI) and race with incident prostate cancer were compared for observed versus imputation-enhanced outcomes using incident density ratios.ResultsAccounting for differential biopsy assessment, the previously reported positive linear trend between BMI and prostate cancer in African American men was not observed; no BMI association was found among Non-Hispanic White men.ConclusionsDifferential disease classification among men who may be recommended to undergo and then consider whether to accept a prostate biopsy leads to inaccurate identification of prostate cancer risk factors. Imputing a man’s prostate cancer status reduces detection bias. Covariate adjustment does not address the problem of outcome misclassification. Cohorts evaluating incident prostate cancer should collect longitudinal screening and biopsy data to adjust for this potential bias. |
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| Keywords: | Risk factor Prevention Prostate cancer Differential misclassification |
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