Maarten C Bosland1,2, Oluwarotimi S Nettey3, Adekoyejo A Phillips4, Charles C Anunobi4, Oluyemi Akinloye5, Ima-Obong A Ekanem6, Ima-Abasi E Bassey6, Vikas Mehta1, Virgilia Macias1, Theodorus H van der Kwast7, Adam B Murphy3,8. 1. Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA. 2. Center for Global Health, University of Illinois at Chicago, Chicago, Illinois, USA. 3. Department of Urology, Northwestern University, Chicago, Illinois, USA. 4. Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Lagos, Nigeria. 5. Department of Laboratory Medicine, College of Medicine & Centre for Genomics of Non-communicable Diseases and Personalized Healthcare, University of Lagos, Lagos, Nigeria. 6. Department of Pathology, Faculty of Medicine, College of Medical Sciences, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria. 7. Laboratory Medicine Program, University Health Network, Toronto, ON, Canada. 8. Institute for Global Health, Northwestern University, Chicago, Illinois, USA.
Abstract
BACKGROUND AND OBJECTIVES: Prostate cancer is the most commonly diagnosed cancer in Nigerian men despite the lack of PSA based screening. Current prevalence estimates in Nigeria are based on cancer registry data obtained primarily from hospital admissions and therefore not truly reflective of prostate cancer incidence. Prior autopsy series did not adhere to modern pathologic quality practices. The aim of this study was to explore the prevalence of asymptomatic prostate cancer among Nigerian men at the time of autopsy. METHODS: Prostates were collected at autopsy at the Universities of Lagos and Calabar Teaching Hospitals from men aged more than 40 who died from causes other than prostate cancer. Thirty-nine prostates from Nigerian men autopsied in 2017 to 2018 were formalin-fixed, weighed, and sliced at 4 mm intervals. Haematoxylin and eosin-stained paraffin sections were prepared from these slices. Presence and Gleason grade of prostatic adenocarcinomas and presence of high-grade prostatic intraepithelial neoplasia (HGPIN) were recorded. RESULTS: Mean age of cases was 55 ± 11 years and mean prostatic weight was 23.0 ± 10.9 g. The crude prevalence of HGPIN was 20.6%. Overall crude prevalence of prostate cancer was 8.8% (n = 34), increasing from 8.3% for men aged 40-59 (n = 23) to 10.0% for men ≥60 years old (n = 10). Two tumors were small and had Gleason Grade 3 + 3 or 3 + 4, and one large stage T3 tumor with Gleason Grade 4 + 3 disease and neuroendocrine appearance was found in a 54-year-old man. CONCLUSIONS: The 8.8% prevalence of subclinical prostate cancer at autopsy was similar to previously reported Nigerian studies with more limited tissue sampling (6.7%-10%), but considerably lower than estimates in other populations, including African Americans. Our findings suggest that latent, clinically asymptomatic prostate cancer is less frequent in Nigerians than in African Americans, despite shared genetic ancestry. Future studies with increased sample size are warranted to provide insight in the natural history and true prevalence of prostate cancer in West Africa.
BACKGROUND AND OBJECTIVES: Prostate cancer is the most commonly diagnosed cancer in Nigerian men despite the lack of PSA based screening. Current prevalence estimates in Nigeria are based on cancer registry data obtained primarily from hospital admissions and therefore not truly reflective of prostate cancer incidence. Prior autopsy series did not adhere to modern pathologic quality practices. The aim of this study was to explore the prevalence of asymptomatic prostate cancer among Nigerian men at the time of autopsy. METHODS: Prostates were collected at autopsy at the Universities of Lagos and Calabar Teaching Hospitals from men aged more than 40 who died from causes other than prostate cancer. Thirty-nine prostates from Nigerian men autopsied in 2017 to 2018 were formalin-fixed, weighed, and sliced at 4 mm intervals. Haematoxylin and eosin-stained paraffin sections were prepared from these slices. Presence and Gleason grade of prostatic adenocarcinomas and presence of high-grade prostatic intraepithelial neoplasia (HGPIN) were recorded. RESULTS: Mean age of cases was 55 ± 11 years and mean prostatic weight was 23.0 ± 10.9 g. The crude prevalence of HGPIN was 20.6%. Overall crude prevalence of prostate cancer was 8.8% (n = 34), increasing from 8.3% for men aged 40-59 (n = 23) to 10.0% for men ≥60 years old (n = 10). Two tumors were small and had Gleason Grade 3 + 3 or 3 + 4, and one large stage T3 tumor with Gleason Grade 4 + 3 disease and neuroendocrine appearance was found in a 54-year-old man. CONCLUSIONS: The 8.8% prevalence of subclinical prostate cancer at autopsy was similar to previously reported Nigerian studies with more limited tissue sampling (6.7%-10%), but considerably lower than estimates in other populations, including African Americans. Our findings suggest that latent, clinically asymptomatic prostate cancer is less frequent in Nigerians than in African Americans, despite shared genetic ancestry. Future studies with increased sample size are warranted to provide insight in the natural history and true prevalence of prostate cancer in West Africa.
Authors: William G Nelson; Otis W Brawley; William B Isaacs; Elizabeth A Platz; Srinivasan Yegnasubramanian; Karen S Sfanos; Tamara L Lotan; Angelo M De Marzo Journal: J Clin Invest Date: 2022-02-01 Impact factor: 14.808