Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Clinical
  • Published:

Prostate cancer risk factors in black and white men in the NIH-AARP Diet and Health Study

Prostate Cancer and Prostatic Diseases volume 22, pages 91–100 (2019)Cite this article

Subjects

Abstract

Background

There are few prospective studies comparing race-specific associations between diet, nutrients, and health-related parameters, and prostate cancer risk.

Methods

Race-specific prostate cancer risk associations were examined among men in the National Institutes of Health (NIH)-AARP Diet and Health Study. We identified 1417 cases among black men (209 advanced), and 28,845 among white men (3898 advanced). Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). We also evaluated the cumulative change in the HR for black race following adjustment for each factor.

Results

Race-specific prostate cancer associations were similar in black and white men across disease subtypes only for history of diabetes (overall : HR = 0.77, 95% CI: 0.65–0.90 and HR = 0.72, 95% CI: 0.69–0.76, respectively; Pinteraction = 0.66). By contrast, there was a positive risk association with height for white men  and  inverse for black men (Pinteraction: non-advanced = 0.01; advanced = 0.04). This difference remained among men with at least 2 years of follow-up for non-advanced (Pinteraction = 0.01), but not advanced disease (Pinteraction = 0.24); or after adjustment for prostate cancer screening (non-advanced Pinteraction = 0.53, advanced Pinteraction = 0.31). The only other evidence of interaction with race was observed for dietary vitamin D intake and non-advanced disease, but only after adjustment for screening (Pinteraction = 0.02). Cumulative adjustment for each factor increased the HR for black race by 32.9% for overall cancer and 12.4% for advanced disease.

Conclusions

Our data suggest few of the dietary, nutrient, and health-related factors associated with prostate cancer risk in predominantly non-Hispanic white men were associated with risk in black men, and adjustment for these factors widen the black–white difference in risk. Larger studies of black men, particularly with prospective data, are needed to help identify risk factors relevant to this population.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  Google Scholar 

  2. American Cancer Society. Cancer Facts & Figures for African Americans 2016-2018. Atlanta: American Cancer Society, 2016.

  3. Chornokur G, Dalton K, Borysova ME, Kumar NB. Disparities at presentation, diagnosis, treatment, and survival in African American men, affected by prostate cancer. Prostate. 2011;71:985–97.

    Article  Google Scholar 

  4. Freedland SJ, Isaacs WB. Explaining racial differences in prostate cancer in the United States: sociology or biology? Prostate. 2005;62:243–52.

    Article  Google Scholar 

  5. Jones BA, Liu WL, Araujo AB, Kasl SV, Silvera SN, Soler-Vila H, et al. Explaining the race difference in prostate cancer stage at diagnosis. Cancer Epidemiol Biomark Prev. 2008;17:2825–34.

    Article  Google Scholar 

  6. Martin DN, Starks AM, Ambs S. Biological determinants of health disparities in prostate cancer. Curr Opin Oncol. 2013;25:235–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Martin DN, Lam TK, Brignole K, Ashing KT, Blot WJ, Burhansstipanov L, et al. Recommendations for cancer epidemiologic research in understudied populations and implications for future needs. Cancer Epidemiol Biomark Prev. 2016;25:573–80.

    Article  Google Scholar 

  8. Kolonel LN, Hankin JH, Whittemore AS, Wu AH, Gallagher RP, Wilkens LR, et al. Vegetables, fruits, legumes and prostate cancer: a multiethnic case-control study. Cancer Epidemiol Biomark Prev. 2000;9:795–804.

    CAS  Google Scholar 

  9. Vogt TM, Mayne ST, Graubard BI, Swanson CA, Sowell AL, Schoenberg JB, et al. Serum lycopene, other serum carotenoids, and risk of prostate cancer in US Blacks and Whites. Am J Epidemiol. 2002;155:1023–32.

    Article  CAS  Google Scholar 

  10. Whittemore AS, Kolonel LN, Wu AH, John EM, Gallagher RP, Howe GR, et al. Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada. J Natl Cancer Inst. 1995;87:652–61.

    Article  CAS  Google Scholar 

  11. Vogt TM, Ziegler RG, Graubard BI, Swanson CA, Greenberg RS, Schoenberg JB, et al. Serum selenium and risk of prostate cancer in U.S. blacks and whites. Int J Cancer. 2003;103:664–70.

    Article  CAS  Google Scholar 

  12. Jackson M, Tulloch-Reid M, Walker S, McFarlane-Anderson N, Bennett F, Francis D, et al. Dietary patterns as predictors of prostate cancer in Jamaican men. Nutr Cancer. 2013;65:367–74.

    Article  CAS  Google Scholar 

  13. Hayes RB, Ziegler RG, Gridley G, Swanson C, Greenberg RS, Swanson GM, et al. Dietary factors and risks for prostate cancer among blacks and whites in the United States. Cancer Epidemiol Biomark Prev. 1999;8:25–34.

    CAS  Google Scholar 

  14. Sanderson M, Coker AL, Logan P, Zheng W, Fadden MK. Lifestyle and prostate cancer among older African-American and Caucasian men in South Carolina. Cancer Causes Control. 2004;15:647–55.

    Article  Google Scholar 

  15. Rowland GW, Schwartz GG, John EM, Ingles SA. Calcium intake and prostate cancer among African Americans: effect modification by vitamin D receptor calcium absorption genotype. J Bone Miner Res. 2012;27:187–94.

    Article  CAS  Google Scholar 

  16. Ben-Shlomo Y, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F, et al. The risk of prostate cancer amongst black men in the United Kingdom: the PROCESS cohort study. Eur Urol. 2008;53:99–105.

    Article  Google Scholar 

  17. Schatzkin A, Subar AF, Thompson FE, Harlan LC, Tangrea J, Hollenbeck AR, et al. Design and serendipity in establishing a large cohort with wide dietary intake distributions: the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol. 2001;154:1119–25.

    Article  CAS  Google Scholar 

  18. Michaud D, Midthune D, Hermansen S, Leitzmann M, Harlan L, Kipnis V, et al. Comparison of cancer registry case ascertainment with SEER estimates and self-reporting in a subset of the NIH-AARP Diet and Health Study. J Regist Manag. 2005;32:70–75.

    Google Scholar 

  19. Durrleman S, Simon R. Flexible regression models with cubic splines. Stat Med. 1989;8:551–61.

    Article  CAS  Google Scholar 

  20. Park SY, Haiman CA, Cheng I, Park SL, Wilkens LR, Kolonel LN, et al. Racial/ethnic differences in lifestyle-related factors and prostate cancer risk: the Multiethnic Cohort Study. Cancer Causes Control. 2015;26:1507–15.

    Article  Google Scholar 

  21. Platz EA, Rimm EB, Willett WC, Kantoff PW, Giovannucci E. Racial variation in prostate cancer incidence and in hormonal system markers among male health professionals. J Natl Cancer Inst. 2000;92:2009–17.

    Article  CAS  Google Scholar 

  22. Atchison EA, Gridley G, Carreon JD, Leitzmann MF, McGlynn KA. Risk of cancer in a large cohort of U.S. veterans with diabetes. Int J Cancer. 2011;128:635–43.

    Article  CAS  Google Scholar 

  23. Bansal D, Bhansali A, Kapil G, Undela K, Tiwari P. Type 2 diabetes and risk of prostate cancer: a meta-analysis of observational studies. Prostate Cancer Prostatic Dis. 2013;16:151–8. S151

    Article  CAS  Google Scholar 

  24. Rastmanesh R, Hejazi J, Marotta F, Hara N. Type 2 diabetes: a protective factor for prostate cancer? An overview of proposed mechanisms. Clin Genitourin Cancer. 2014;12:143–8.

    Article  Google Scholar 

  25. Travis RC, Appleby PN, Martin RM, Holly JMP, Albanes D, Black A, et al. A meta-analysis of individual participant data reveals an association between circulating levels of IGF-I and prostate cancer risk. Cancer Res. 2016;76:2288–300.

    Article  CAS  Google Scholar 

  26. World Cancer Research Fund International/American Institute for Cancer Research Continuous Report Update Project Report. Diet, Nutrition, Physical Acitivity, and Prostate Cancer, 2014.

  27. Mordukhovich I, Reiter PL, Backes DM, Family L, McCullough LE, O’Brien KM, et al. A review of African American-white differences in risk factors for cancer: prostate cancer. Cancer Causes Control. 2011;22:341–57.

    Article  Google Scholar 

  28. Kabat GC, Kim MY, Hollenbeck AR, Rohan TE. Attained height, sex, and risk of cancer at different anatomic sites in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2014;25:1697–706.

    Article  Google Scholar 

  29. Rodriguez C, Patel AV, Calle EE, Jacobs EJ, Chao A, Thun MJ. Body mass index, height, and prostate cancer mortality in two large cohorts of adult men in the United States. Cancer Epidemiol Biomark Prev. 2001;10:345–53.

    CAS  Google Scholar 

  30. Habel LA, Van Den Eeden SK, Friedman GD. Body size, age at shaving initiation, and prostate cancer in a large, multiracial cohort. Prostate. 2000;43:136–43.

    Article  CAS  Google Scholar 

  31. Zuccolo L, Harris R, Gunnell D, Oliver S, Lane JA, Davis M, et al. Height and prostate cancer risk: a large nested case-control study (ProtecT) and meta-analysis. Cancer Epidemiol Biomark Prev. 2008;17:2325–36.

    Article  CAS  Google Scholar 

  32. Ahn J, Moore SC, Albanes D, Huang WY, Leitzmann MF, Hayes RB, et al. Height and risk of prostate cancer in the prostate, lung, colorectal, and ovarian cancer screening trial. Br J Cancer. 2009;101:522–5.

    Article  CAS  Google Scholar 

  33. Freedland SJ, Aronson WJ, Trock B, Cohen P, Kane CJ, Amling CL, et al. Racial differences in prognostic value of adult height for biochemical progression following radical prostatectomy. Clin Cancer Res. 2005;11:7735–42.

    Article  CAS  Google Scholar 

  34. Platz EA, Pollak MN, Rimm EB, Majeed N, Tao Y, Willett WC, et al. Racial variation in insulin-like growth factor-1 and binding protein-3 concentrations in middle-aged men. Cancer Epidemiol Biomark Prev. 1999;8:1107–10.

    CAS  Google Scholar 

  35. McGreevy K, Hoel B, Lipsitz S, Bissada N, Hoel D. Racial and anthropometric differences in plasma levels of insulin-like growth factor I and insulin-like growth factor binding protein-3. Urology. 2005;66:587–92.

    Article  Google Scholar 

  36. Gilbert R, Martin RM, Beynon R, Harris R, Savovic J, Zuccolo L, et al. Associations of circulating and dietary vitamin D with prostate cancer risk: a systematic review and dose-response meta-analysis. Cancer Causes Control. 2011;22:319–40.

    Article  Google Scholar 

  37. Xu Y, Shao X, Yao Y, Xu L, Chang L, Jiang Z, et al. Positive association between circulating 25-hydroxyvitamin D levels and prostate cancer risk: new findings from an updated meta-analysis. J Cancer Res Clin Oncol. 2014;140:1465–77.

    Article  CAS  Google Scholar 

  38. Swami S, Krishnan AV, Feldman D. Vitamin D metabolism and action in the prostate: implications for health and disease. Mol Cell Endocrinol. 2011;347:61–69.

    Article  CAS  Google Scholar 

  39. Layne TM, Weinstein SJ, Graubard BI, Ma X, Mayne ST, Albanes D. Serum 25-hydroxyvitamin D, vitamin D binding protein, and prostate cancer risk in black men. Cancer. 2017;123:2698–704.

    Article  CAS  Google Scholar 

  40. Park SY, Murphy SP, Wilkens LR, Stram DO, Henderson BE, Kolonel LN. Calcium, vitamin D, and dairy product intake and prostate cancer risk: the Multiethnic Cohort Study. Am J Epidemiol. 2007;166:1259–69.

    Article  Google Scholar 

  41. Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr. 2005;81:1147–54.

    Article  CAS  Google Scholar 

  42. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.

    Article  CAS  Google Scholar 

  43. O’Neil CE, Nicklas TA, Keast DR, Fulgoni VL. Ethnic disparities among food sources of energy and nutrients of public health concern and nutrients to limit in adults in the United States: NHANES 2003-2006. Food Nutr Res. 2014;58:15784.

    Article  Google Scholar 

  44. Batai K, Murphy AB, Nonn L, Kittles RA. Vitamin D and immune response: implications for prostate cancer in African Americans. Front Immunol. 2016;7:53.

    Article  Google Scholar 

  45. Hardiman G, Savage SJ, Hazard ES, Wilson RC, Courtney SM, Smith MT, et al. Systems analysis of the prostate transcriptome in African-American men compared with European-American men. Pharmacogenomics. 2016;17:1129–43.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This research was supported [in part] by the Intramural Research Program of the NIH, National Cancer Institute. Cancer incidence data from the Atlanta metropolitan area were collected by the Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. Cancer incidence data from California were collected by the California Cancer Registry, California Department of Public Health’s Cancer Surveillance and Research Branch, Sacramento, California. Cancer incidence data from the Detroit metropolitan area were collected by the Michigan Cancer Surveillance Program, Community Health Administration, Lansing, Michigan. The Florida cancer incidence data used in this report were collected by the Florida Cancer Data System (Miami, Florida) under contract with the Florida Department of Health, Tallahassee, Florida. The views expressed herein are solely those of the authors and do not necessarily reflect those of the FCDC or FDOH. Cancer incidence data from Louisiana were collected by the Louisiana Tumor Registry, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana. Cancer incidence data from New Jersey were collected by the New Jersey State Cancer Registry, The Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey. Cancer incidence data from North Carolina were collected by the North Carolina Central Cancer Registry, Raleigh, North Carolina. Cancer incidence data from Pennsylvania were supplied by the Division of Health Statistics and Research, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations or conclusions. Cancer incidence data from Arizona were collected by the Arizona Cancer Registry, Division of Public Health Services, Arizona Department of Health Services, Phoenix, Arizona. Cancer incidence data from Texas were collected by the Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas. Cancer incidence data from Nevada were collected by the Nevada Central Cancer Registry, Division of Public and Behavioral Health, State of Nevada Department of Health and Human Services, Carson City, Nevada. We are indebted to the participants in the NIH-AARP Diet and Health Study for their outstanding cooperation. We also thank Sigurd Hermansen and Kerry Grace Morrissey from Westat for study outcomes ascertainment and management and Leslie Carroll at Information Management Services for data support and analysis.

Author contributions

DA, STM, XM, and BIG designed the research; TML conducted and analyzed the data; TML, DA, STM, XM, and BIG wrote the paper; TML and DA have primary responsibility for the final content. All authors read and approved the final manuscript.

Funding

This work was supported by the Yale-NCI pre-doctoral training grant T32 CA105666 to STM and XM, and by the Intramural Research Program of the National Cancer Institute at the National Institutes of Health.

Author information

Author notes

  1. Susan T. Mayne

    Present address: Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD, USA

Authors and Affiliations

  1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    Tracy M. Layne, Barry I. Graubard & Demetrius Albanes

  2. Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA

    Xiaomei Ma & Susan T. Mayne

  3. Yale Comprehensive Cancer Center, Yale University, New Haven, CT, USA

    Xiaomei Ma

Authors
  1. Tracy M. Layne
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Barry I. Graubard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiaomei Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Susan T. Mayne
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Demetrius Albanes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tracy M. Layne.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Layne, T.M., Graubard, B.I., Ma, X. et al. Prostate cancer risk factors in black and white men in the NIH-AARP Diet and Health Study. Prostate Cancer Prostatic Dis 22, 91–100 (2019). https://doi.org/10.1038/s41391-018-0070-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41391-018-0070-9

This article is cited by

Search

Advanced search

Quick links