Racial disparities in cigarette smoking and alcohol use and its association with prostate cancer aggressiveness.

A41

Background:
 Cigarette smoking and alcohol consumption have been linked to risk of several cancers. However, very limited literature is available on association between prostate cancer incidence and mortality and cigarette smoking and alcohol consumption. Despite prostate cancer incidence in African-Americans being 50% higher than Caucasians, and mortality rates more than two fold higher, the disparities in smoking and alcohol drinking behaviors of African-American males compared to Caucasian males and the relation to aggressiveness of prostate cancer have been inadequately addressed. This study examines whether the prevalence of cigarette smoking and alcohol consumption is higher in African-American males compared to Caucasian males in a population-based prostate cancer case-only study which may partially explain the disparity of aggressive prostate cancer among African-Americans.
 Methods:
 This project utilizes the data from the North Carolina - Louisiana Prostate Cancer Project, a population-based case-only study, to examine the hypothesis. Data from 1,550 incident prostate cancer cases, 695 African-American men and 855 Caucasian men, recruited through August 31, 2007, was used for this analysis. Among this sample population, prostate cancer aggressiveness based on clinical information at the time of diagnosis is available for 878 subjects - 162 high aggressive, 278 intermediate aggressive, and 438 low aggressive prostate cancer cases.
 Results:
 A significantly (p= 0.002) higher percentage of African-Americans (73.6%) reported ever having smoked 100 cigarettes compared to Caucasians (64.0%). The percentage of subjects who reported current smoking (defined as smoking at the time of diagnosis or within past 12 months prior to diagnosis) is also significantly higher among African-Americans than Caucasians (26.6% vs 12.0% respectively, p < 0.001). However, a higher percentage (59.8%) of Caucasians reported regular alcohol consumption within 12 months before diagnosis when compared to African-Americans (46.4%). Current smoking status was associated with 171% increased risk of high aggressive prostate cancer when compared to non-current smokers among African-Americans (OR = 2.71; 95%CI = 1.17, 6.25) adjusting for pack-years, alcohol, age, PSA screening history, and SES. An elevated but non-significant association was found among Caucasian males (OR = 1.55). On the other hand, in Caucasians, the odds ratio of developing high aggressive cancer for one drink of wine per day is 2.27 (95%CI=1.19, 4.34) and for more than one drink of wine per day is 2.46 (95%CI = 0.98, 2.63) when compared to non-drinkers. No significant association was seen between alcohol drinking and prostate cancer aggressiveness in African-Americans.
 Conclusion:
 Higher percentage of African-American prostate cancer cases in the North Carolina - Louisiana Prostate Cancer Project reported cigarette smoking than Caucasians and were higher than the national estimates from the National Health and Nutritional Examination Survey. Smoking was associated with high aggressiveness of prostate cancer in African-Americans but not Caucasians. Wine consumption on the other hand, was associated with high aggressiveness in Caucasians but not African-Americans.
 Grant Sponsor: Department of Defense ; “DAMD 17-03-2-0052”