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Racial differences in prostate cancer risk remain among US servicemen with equal access to care
Author(s) -
Wells Timothy S.,
Bukowinski Anna T.,
Smith Tyler C.,
Smith Besa,
Dennis Leslie K.,
Chu Laura K.,
Gray Gregory C.,
Ryan Margaret A.K.
Publication year - 2009
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.21105
Subject(s) - medicine , prostate cancer , hazard ratio , demography , context (archaeology) , epidemiology , population , confidence interval , cancer , cohort , prostate cancer screening , proportional hazards model , gerontology , gynecology , prostate specific antigen , environmental health , paleontology , sociology , biology
BACKGROUND Prostate cancer is the most common cancer among US men, however, the etiology remains unclear. Yet, one consistency is that black non‐Hispanic men are at increased risk for prostate cancer compared to white, non‐Hispanic men. The goal of this study was to assess relations between demographic and other potential prostate cancer risk factors in the context of the US military healthcare system, which provides equal access to all US servicemen. METHODS Military healthcare and demographic data were used to describe risk factors for prostate cancer in the US military from September 1993 to September 2003. Cox's proportional hazards regression was employed to model the time to prostate cancer hospitalization. RESULTS Four hundred eight first prostate cancer hospitalizations were identified among 2,761,559 servicemen. The adjusted rate per 100,000 persons rose from 1.41 to 3.62 for white non‐Hispanic men and 1.43 to 6.08 for black non‐Hispanic men by the end of the study. The increasing incidence over time for combined race/ethnic groups was similar to trends reported in the Surveillance, Epidemiology, and End Results Program for the US civilian population. No association was observed between occupation and prostate cancer hospitalization. However, black non‐Hispanic men were at increased risk compared with white non‐Hispanic men (hazard ratio = 2.72, 95% confidence interval: 2.12, 3.49). CONCLUSIONS No association was observed between occupation and prostate cancer hospitalization. In this relatively young cohort, black non‐Hispanic race/ethnicity was found to be predictive of prostate cancer, and this association existed regardless of access to care and socioeconomic status. Prostate 70: 727–734, 2010. © 2009 Wiley‐Liss, Inc.