Abstract A72: Prostate cancer incidence and mortality in Barbados, West Indies: Findings from the Barbados National Cancer Study Free

Purpose: To describe the incidence of prostate cancer and subsequent mortality in the predominantly African-origin population of Barbados,West Indies. This population shares a common heredity with African Americans (with lower admixture), and experiences similarly high rates of lifestylerelated noncommunicable disease.

Methods: We identified all new cases of histologically confirmed prostate cancer occurring in Barbados between July 01, 2002 and December 31, 2007. We used death certification records to ascertain mortality for a 10-year period commencing January 1995. We identified prostate cancer as the underlying cause of death using nosology algorithms, and classified this cause as definite (a single listed cause, or death directly attributable to prostate cancer, including metastatic disease), or probable (multiple causes of death cited; death likely attributable to prostate cancer).

Results: During the study period, 923 cases of prostate cancer were diagnosed for a rate of 158.9 (95% Confidence Interval: 148.7 – 169.6) per 100,000 standardized to the U.S. population. Comparable rates reported in the USA SEER (2000 – 2005) were 251.9 (95% CI: 249.2 – 254.6) and 158.6 (95% CI: 158.0 – 159.3) per 100,000 in African-American and White men, respectively. Age specific rates in Barbados increased from 5.3 (95% CI: 1.1 – 15.5) per 100,000 among those aged 40 to 44 to a peak at 988.7 (95% CI: 852.8 – 1140.2) per 100,000 at 70 to 74 years, declining thereafter. For the period 2002 – 2005, annual age-adjusted incidence was between 1.3 and 1.9 times higher in African American men (p<0.001 in all cases). During the 10-year period, there were 801 certifications of definite or probable prostate cancer-related deaths. Annual mortality rates (age-standardized to the US population) ranged from 52.3 to 88.8 per 100,000 person years among Barbadians, rates similar to those experienced by African-Americans during the same period (56.2 to 78.3 per 100,000).

Discussion: Prostate cancer incidence was lower in Barbadian than African American men, and was more comparable with rates in white American men. This may be partly due to a lower prevalence of PSA screening in Barbados with clinically more significant disease at presentation. In contrast, mortality rates in Barbadians were similar to those of African- mericans, highlighting the need for clinical and public health interventions to reduce the disproportionate disease burden.