Abstract C59: The role of adiposity in racial and ethnic disparities in prostate cancer occurrence and progression: A systematic literature review
Authors: Martin Iman K. , Stayner Leslie T. , Wilder Jocelyn P. , Mahmoud Abeer M. , Murphy Adam B. , Freeman Vincent L. 
Published: May 2013

Abstract
Background: Black men develop and die from prostate cancer (PCa) more than any other racial group. According to recent United States (US) statistics, PCa incidence and mortality rates in Black men are 1.6 and 2.4 times that of their White (WH) counterparts, respectively. Various biologic, behavioral, environmental, demographic, and social-contextual factors have been shown to be components of the persisting disparities in outcomes. However, it is not clear how aspects of body composition, particularly adiposity, contribute to racial and ethnic disparities in PCa occurrence and course. Current reviews on the adiposity relationship have tended not to adequately address this. Therefore, we conducted a systematic review of the literature examining the role of adiposity in racial disparities in prostate cancer.
Methods: The US National Library of Medicine National Institutes of Health PubMed database was searched for English articles published through October 1, 2011. Criteria for selection were: 1) an adiposity-related factor (BMI, WHR etc.) was an exposure of interest and related to a PCa outcome (diagnosis, progression, prostate cancer-specific mortality); 2) focused on racial disparities in an adiposity association with PCa; 3) the participant sample included men of predominant African Ancestry [AA] (e.g. Black, African American, Ghanaian etc.); 4) and race-stratified, particularly AA specific, effect estimates for PCa occurrence, mortality, or progression were reported. Adjustment for race in a multivariate model alone was not sufficient for inclusion in the review analysis. No reviews, editorials, or comments were included in the review, although they were cited for background content.
Results: Many of the available reviews on adiposity and PCa racial disparities focused on disparities in screening, rather than incidence, progression, or mortality. The articles which did address occurrence and outcomes often did not present race-specific effect estimates and simply adjusted for race in multivariate models. The available evidence suggests a unique role of adiposity-related factors (i.e. body size, body fat distribution, and fatty acid intake,) in the risk of PCa occurrence, progression, differences in treatment efficacy, and PCa-specific death. Lack of studies including sufficiently large numbers of AA prohibited reporting of race-specific estimates in many studies, especially in studies involving molecular biology and genetics.
Conclusions: Incidence, morbidity, and mortality are highest in Black men. Clarifying the role of adiposity in PCa disparities is of great importance. Further clinical research illuminating adiposity related targets for intervention and mechanisms is crucial in this highly affected group.
Citation Format: Iman K. Martin, Leslie T. Stayner, Jocelyn P. Wilder, Abeer M. Mahmoud, Adam B. Murphy, Vincent L. Freeman. The role of adiposity in racial and ethnic disparities in prostate cancer occurrence and progression: A systematic literature review [abstract]. In: Proceedings of the AACR Special Conference on Advances in Prostate Cancer Research; 2012 Feb 6-9; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2012;72(4 Suppl):Abstract nr C59.