SEER and Gene Expression Data Analysis Deciphers Racial Disparity Patterns in Prostate Cancer Mortality and the Public Health Implication.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Data Analysis* ; Gene Expression Regulation, Neoplastic* ; Public Health* ; SEER Program*; Prostatic Neoplasms/*genetics ; Prostatic Neoplasms/*mortality ; Racial Groups/*genetics; Black or African American/genetics ; Age Factors ; Aged ; Aged, 80 and over ; Cluster Analysis ; Demography ; Gene Expression Profiling ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Grading ; Registries ; Regression Analysis ; Survival Analysis ; White People/genetics

A major racial disparity in prostate cancer (PCa) is that African American (AA) patients have a higher mortality rate than European American (EA) patients. We filtered the SEER 2009-2011 records and divided them into four groups regarding patient races and cancer grades. On such a partition, we performed a series of statistical analyses to further clarify the aforementioned disparity. Molecular evidence for a primary result of the epidemiological analysis was obtained from gene expression data. The results include: (1) Based on the registry-specific measures, a significant linear regression of total mortality rate (as well as PCa specific mortality rate) on the percentage of (Gleason pattern-based) high-grade cancers (PHG) is demonstrated in EAs (p < 0.01) but not in AAs; (2) PHG and its racial disparity are differentiated across ages and the groups defined by patient outcomes; (3) For patients with cancers in the same grade category, i.e. the high or low grade, the survival stratification between races is not significant in most geographical areas; and (4) The genes differentially expressed between AAs' and EAs' tumors of the same grade category are relatively rare. The perception that prostate tumors are more lethal in AAs than in EAs is reasonable regarding AAs' higher PHG, while high grade alone could not imply aggressiveness. However, this perception is questionable when the comparison is focused on cases within the same grade category. Supporting observations for this conclusion hold a remarkable implication for erasing racial disparity in PCa. That is, "Equal grade, equal outcomes" is not only a verifiable hypothesis but also an achievable public health goal.

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P01 CA214091 United States CA NCI NIH HHS; P20 GM103424 United States GM NIGMS NIH HHS; U19 AG055373 United States AG NIA NIH HHS; U54 MD007595 United States MD NIMHD NIH HHS

Date Created: 20200424 Date Completed: 20201130 Latest Revision: 20240329

20240329

PMC7176737

10.1038/s41598-020-63764-4

32321981