Risk for prostate cancer diagnosis among men of Arabic ethnicity

The prevalence of prostate cancer in Arab populations is significantly lower than that in Western (predominantly Caucasian) populations. However, we have very few good data on the relative risks for a diagnosis of prostate cancer in men of Arab as opposed to Caucasian ethnicity. We also know very little about what affects risk for localized, progressive, and metastatic subsets of prostate cancer in Arab populations.

Al-Abdin et al. carried out a retrospective analysis of data that had been prospectively collected at the urology clinics at McGill University Health Center (MUHC) in Montreal, Canada, and King Saud University Hospital (KSUH) in Riyad, Saudi Arabia, over a period of 5 consecutive years. The data analysis was limited to men who had an elevated PSA level (> 4 ng/ml) or a rising PSA level and a negative rectal exam.

Here are their key findings:

  • 1,403 Canadian and 414 Saudi patients were evaluated for inclusion in the study.
  • 717 Canadian and 158 Saudi patients were actually included in the study’s database.
  • The median ages of the two patient cohorts were
    • 64 years for the Canadian patients
    • 68 years for the Saudi patients
    • This difference is statistically significant (P < 0.0001)
  • Median serum PSA levels for the two patient cohorts were
    • 6.1 ng/ml for the Canadian patients
    • 5.2 ng/ml for the Saudi patients
  • Median estimates of prostate sizes for the two patient cohorts were
    • 47.3 g for the Canadian patients
    • 64.5 g for the Saudi patients
  • Median PSA densities for the two patient cohorts were
    • 0.12 ng/ml/g for the Canadian patients
    • 0.08 ng/ml/g for the Saudi patients

However, the abstract does not tell us what percentages of the two cohorts of men were actually found to have prostate cancer on biopsy. It does tell us that, compared to the Canadian patients, there was a significantly lower rate of detection of prostate cancer among Saudi patients of < 60 years of age and with PSA values < 10 ng/ml.

The age difference between the two cohorts of patients is also important. There may also be more helpful data in the full text of this article, which we have not seen. However, as written this abstract does not really tell us a great deal about anything. Here are some key questions that men of Arab ethnicity may well want get answers to:

  • Does their risk for prostate cancer increase if they move to and live in Western countries and adopt a more Western diet compared to the traditional Arabic diet?
  • Is their real risk for clinically significant prostate cancer in Arabic environments higher, lower, or just the same as that observed in Western counties, or are the available data more reflective of things like access to medical care and life expectancy?
  • Does PSA testing have the same value in the detection of risk for prostate cancer in Arabic populations as it does in Caucasians?

It would seem to The “New” Prostate Cancer InfoLink that there is a lot of work to be done to identify the real risk for prostate cancer among men of Arabic ethnicity.

4 Responses

  1. Genital and anal hygiene is much higher in Arabs. Please comment.

  2. Dear Johnny:

    I know of no reason why relative levels of genital and rectal hygiene would be associated with risk for prostate cancer (although it might be associated with risk for post-biopsy infection).

  3. Thanks for your reply. Is it worth some reflection though, as this has not been disproved either and, for example, seeing as smoking causes throat or lung cancer (another source of harmful bacteria)?

  4. Jonny:

    There is no evidence whatsoever that risk for prostate cancer is associated with any form of bacterial or viral infection. This has been studied at considerable length over the years.

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