Abstract A40: Untangling the ethnic differences among black men relative to prostate cancer burden: The Florida CaPCaS study
Authors: Odedina Folakemi , Young Mary Ellen , Dagne Getachew , Williams Christopher , Pereira Deidre , Gilbert Lauren , Egensteiner Eva , Stokes Kenneth , Hill Christopher ,   Community Advisory Board CaPCaS
Published: May 2016

Background and Objective: Without a doubt, foreign-born Blacks continue to transform the ethnic composition of the Black population in the US. Unfortunately, native-born and foreign-born Blacks are often grouped together in health disparities research. This practice limits our ability to effectively address health disparities, especially with respect to prostate cancer (CaP). One of the goals of the Florida Prostate Cancer Disparity group is to untangle the ethnic differences in CaP disparities. As part of a large-scale study to develop a model of CaP care and survivorship (CaPCaS model) for Black men (BM), the primary objective of this study is to explore the ethnic differences in CaP incidence/morbidity among BM.

Research Strategy: The study population is Florida BM diagnosed with CaP in 2010. Our primary objective is to estimate the ethnic differences in the incidence of CaP among Native-born BM (NBBM), Caribbean-born BM (CBBM) and African-born BM (ABBM). Following appropriate Human Subjects approvals, participants (only BM) were identified through the Florida Cancer Data System (FCDS). The FCDS has collected the number of new cancer cancers diagnosed in the state of Florida annually since 1981. Since the country of birth is not collected as part of cancer registry data, the primary strategy was to contact all the men identified through the FCDS database. Using the published standard procedure by FCDS for recruitment, all BM diagnosed with CaP were contacted to participate in the study. Participant recruitment included: (i) initial patient contact mailing with patient response form; (ii) second mailing with telephone opt-out card; and (iii) telephone call. Following the Florida Department of Health standard procedure, we did not disclose that the patient is being contacted for a study specific to cancer on the cover of study mailings. For participants who agreed to participate in the study, structured telephone survey was employed to collect data on their demographics, including ethnicity and country of birth. Trained Community Health Workers who were African Americans conducted the phone survey. An incentive of $5 Walmart card was sent to all participants.

Results: The FCDS provided a database of 1,813 participants identified as BM diagnosed with CaP in 2010 (most recent completed database). The FCDS does not extract data on patients with a death certificate, thus quite a number of the men were reported to be deceased. In addition, there were bad addresses. A total of 212 completed responses were obtained by phone. Majority of the participants were between 60 and 69 years (48.2%), had only high school diploma (26.1%), and currently married (65.3%). Relative to ethnicity, 67% of participants classified themselves as African-American of American origin (born and grew up in America), 20% as African-American of Caribbean origin (born in one of the Caribbean Islands but now American), 4% as Caribbean, 3.5% as African-American of African origin (born in Africa but now American), 0% as African, and 5.5% as Other/Don't know/Refused. For the CBBM, the most common country of birth are Jamaica, Haiti and Guyana, respectively. For Africa, the most common country of birth is Nigeria.

Conclusion: This study explored the ethnic differences among BM relative to CaP diagnosis in Florida. The findings suggest that the burden of CaP may be lowest among African-born BM compared to CBBM and NBBM. This conclusion is similar to our previously published review of the global burden of CaP in BM. Given the fact that Black populations of African ancestry share ancestral genetic factors that increase their susceptibility to CaP, the question of exogenous factors in the origin, cause, recurrence and survivorship of CaP among Blacks need to be further explored, especially through migration and global studies. Another implication of this study is the importance of studying CaP in US immigrants, especially immigrants from Jamaica, Haiti and Nigeria.

Citation Format: Folakemi Odedina, Mary Ellen Young, Getachew Dagne, Christopher Williams, Deidre Pereira, Lauren Gilbert, Eva Egensteiner, Kenneth Stokes, Christopher Hill, Community Advisory Board CaPCaS. Untangling the ethnic differences among black men relative to prostate cancer burden: The Florida CaPCaS study. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A40.