Presentation, patterns of care, and outcomes of patients with prostate cancer in sub-Saharan Africa: A population-based registry study.
Africa
population-based cancer registration
prostate cancer
staging
survival
treatment
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
15 11 2021
15 11 2021
Historique:
revised:
17
04
2021
received:
31
10
2020
accepted:
18
05
2021
pubmed:
31
7
2021
medline:
11
3
2022
entrez:
30
7
2021
Statut:
ppublish
Résumé
Although prostate cancer (PCa) is the most commonly diagnosed cancer in men of sub-Saharan Africa (SSA), little is known about its management and survival. The objective of the current study was to describe the presentation, patterns of diagnosis, treatment, and survival of patients with PCa in 10 countries of SSA. In this observational registry study with data collection from 2010 to 2018, the authors drew a random sample of 738 patients with PCa who were registered in 11 population-based cancer registries. They described proportions of patients receiving recommended care and presented survival estimates. Multivariable Cox regression was used to calculate hazard ratios comparing the survival of patients with and without cancer-directed therapies (CDTs). The study included 693 patients, and tumor characteristics and treatment information were available for 365 patients, 37.3% of whom had metastatic disease. Only 11.2% had a complete diagnostic workup for risk stratification. Among the nonmetastatic patients, 17.5% received curative-intent therapy, and 27.5% received no CDT. Among the metastatic patients, 59.6% received androgen deprivation therapy. The 3- and 5-year age-standardized relative survival for 491 patients with survival time information was 58.8% (95% confidence interval [CI], 48.5%-67.7%) and 56.9% (95% CI, 39.8%-70.9%), respectively. In a multivariable analysis, survival was considerably poorer among patients without CDT versus those with therapy. This study shows that a large proportion of patients with PCa in SSA are not staged or are insufficiently staged and undertreated, and this results in unfavorable survival. These findings reemphasize the need for improving diagnostic workup and access to care in SSA in order to mitigate the heavy burden of the disease in the region.
Sections du résumé
BACKGROUND
Although prostate cancer (PCa) is the most commonly diagnosed cancer in men of sub-Saharan Africa (SSA), little is known about its management and survival. The objective of the current study was to describe the presentation, patterns of diagnosis, treatment, and survival of patients with PCa in 10 countries of SSA.
METHODS
In this observational registry study with data collection from 2010 to 2018, the authors drew a random sample of 738 patients with PCa who were registered in 11 population-based cancer registries. They described proportions of patients receiving recommended care and presented survival estimates. Multivariable Cox regression was used to calculate hazard ratios comparing the survival of patients with and without cancer-directed therapies (CDTs).
RESULTS
The study included 693 patients, and tumor characteristics and treatment information were available for 365 patients, 37.3% of whom had metastatic disease. Only 11.2% had a complete diagnostic workup for risk stratification. Among the nonmetastatic patients, 17.5% received curative-intent therapy, and 27.5% received no CDT. Among the metastatic patients, 59.6% received androgen deprivation therapy. The 3- and 5-year age-standardized relative survival for 491 patients with survival time information was 58.8% (95% confidence interval [CI], 48.5%-67.7%) and 56.9% (95% CI, 39.8%-70.9%), respectively. In a multivariable analysis, survival was considerably poorer among patients without CDT versus those with therapy.
CONCLUSIONS
This study shows that a large proportion of patients with PCa in SSA are not staged or are insufficiently staged and undertreated, and this results in unfavorable survival. These findings reemphasize the need for improving diagnostic workup and access to care in SSA in order to mitigate the heavy burden of the disease in the region.
Substances chimiques
Androgen Antagonists
0
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4221-4232Subventions
Organisme : Studienstiftung des Deutschen Volkes
Organisme : Deutscher Akademischer Austauschdienst
Organisme : Cusanuswerk
Organisme : Research Department of the American Cancer Society
ID : 43359
Organisme : Bayer Foundation
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.
Références
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394-424. doi:10.3322/caac.21492
Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. Lancet Oncol. 2012;13:790-801. doi:10.1016/S1470-2045(12)70211-5
Seraphin TP, Joko-Fru WY, Kamaté B, et al. Rising prostate cancer incidence in sub-Saharan Africa: a trend analysis of data from the African Cancer Registry Network. Cancer Epidemiol Biomarkers Prev. 2021;30:158-165. doi:10.1158/1055-9965.EPI-20-1005
Jemal A, Bray F, Forman D, et al. Cancer burden in Africa and opportunities for prevention. Cancer. 2012;118:4372-4384. doi:10.1002/cncr.27410
Baratedi WM, Tshiamo WB, Mogobe KD, McFarland DM. Barriers to prostate cancer screening by men in sub-Saharan Africa: an integrated review. J Nurs Scholarsh. 2020;52:85-94. doi:10.1111/jnu.12529
Jalloh M, Niang L, Ndoye M, Labou I, Gueye SM. Prostate cancer in sub Saharan Africa. J Nephrol Urol Res. 2013;1:15-20. doi:10.12970/2310-984X.2013.01.01.4
DeSantis CE, Siegel RL, Sauer AG, et al. Cancer statistics for African Americans, 2016: progress and opportunities in reducing racial disparities. CA Cancer J Clin. 2016;66:290-308. doi:10.3322/caac.21340
McGinley KF, Tay KJ, Moul JW. Prostate cancer in men of African origin. Nat Rev Urol. 2016;13:99-107. doi:10.1038/nrurol.2015.298
DeRouen MC, Schupp CW, Koo J, et al. Impact of individual and neighborhood factors on disparities in prostate cancer survival. Cancer Epidemiol. 2018;53:1-11. doi:10.1016/j.canep.2018.01.003
Krimphove MJ, Cole AP, Fletcher SA, et al. Evaluation of the contribution of demographics, access to health care, treatment, and tumor characteristics to racial differences in survival of advanced prostate cancer. Prostate Cancer Prostatic Dis. 2019;22:125-136. doi:10.1038/s41391-018-0083-4
NCCN Harmonized Guidelines for Sub-Saharan Africa: Prostate Cancer. Version 2.2017. National Comprehensive Cancer Network. Accessed June 25, 2018. https://www.nccn.org/global/what-we-do/harmonized-guidelines
Mottet N, van den Bergh RCN, Briers E, et al. EAU-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. EAU Guidelines Office; 2018.
Finesse AM, Somdyala N, Chokunonga E, Parkin DM, eds. Standard Procedure Manual for Population-Based Cancer Registries in Sub Saharan Africa. 2nd ed. African Cancer Registry Network. Published 2015. Accessed November 21, 2018. https://afcrn.org/index.php/resources2/53-standard-procedure-manual/131-sop
Amin MB, Greene FL, Edge SB, eds. AJCC Cancer Staging Manual. 8th ed. Springer; 2017.
Piñeros M, Parkin DM, Ward K, et al. Essential TNM: a registry tool to reduce gaps in cancer staging information. Lancet Oncol. 2019;20:e103-e111. doi:10.1016/S1470-2045(18)30897-0
Corazziari I, Quinn M, Capocaccia R. Standard cancer patient population for age standardising survival ratios. Eur J Cancer. 2004;40:2307-2316. doi:10.1016/j.ejca.2004.07.002
Noone A, Howlader N, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2015. National Cancer Institute; 2018.
Abdel-Wahab M, Bourque J-M, Pynda Y, et al. Status of radiotherapy resources in Africa: an International Atomic Energy Agency analysis. Lancet Oncol. 2013;14:e168-e175. doi:10.1016/S1470-2045(12)70532-6
Kanavos P. The rising burden of cancer in the developing world. Ann Oncol. 2006;17(suppl 8):viii15-viii23. doi:10.1093/annonc/mdl983
Prostate Cancer Early Detection: NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Version 2.2018. National Comprehensive Cancer Network. Accessed December 16, 2018. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459
Potosky AL. The role of increasing detection in the rising incidence of prostate cancer. JAMA. 1995;273:548. doi:10.1001/jama.1995.03520310046028
Moyer VA. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:120-134. doi:10.7326/0003-4819-157-2-201207170-00459
Brawley OW. Trends in prostate cancer in the United States. J Natl Cancer Inst Monogr. 2012;2012:152-156. doi:10.1093/jncimonographs/lgs035
Esserman L, Shieh Y, Thompson I. Rethinking screening for breast cancer and prostate cancer. JAMA. 2009;302:1685-1692. doi:10.1001/jama.2009.1498
Badmus TA, Adesunkanmi A-RK, Yusuf BM, et al. Burden of prostate cancer in southwestern Nigeria. Urology. 2010;76:412-416. doi:10.1016/j.urology.2010.03.020
Heyns CF, Fisher M, Lecuona A, van der Merwe A. Prostate cancer among different racial groups in the Western Cape: presenting features and management. S Afr Med J. 2011;101:267-270. doi:10.7196/SAMJ.4420
Asamoah FA, Yarney J, Awasthi S, et al. Contemporary radiation treatment of prostate cancer in Africa: a Ghanaian experience. J Glob Oncol. 2018;4:1-13. doi:10.1200/JGO.17.00234
Meara JG, Leather AJM, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386:569-624. doi:10.1016/S0140-6736(15)60160-X
Efstathiou JA, Heunis M, Karumekayi T, et al. Establishing and delivering quality radiation therapy in resource-constrained settings: the story of Botswana. J Clin Oncol. 2016;34:27-35. doi:10.1200/JCO.2015.62.8412
Kingham TP, Alatise OI, Vanderpuye V, et al. Treatment of cancer in sub-Saharan Africa. Lancet Oncol. 2013;14:e158-e167. doi:10.1016/S1470-2045(12)70472-2
Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391:1023-1075. doi:10.1016/S0140-6736(17)33326-3
American Cancer Society. Cancer Facts & Figures 2018. American Cancer Society; 2018.
Barry MJ. Screening for prostate cancer-the controversy that refuses to die. N Engl J Med. 2009;360:1351-1354. doi:10.1056/NEJMe0901166
Jemal A, Fedewa SA, Ma J, et al. Prostate cancer incidence and PSA testing patterns in relation to USPSTF screening recommendations. JAMA. 2015;314:2054-2061. doi:10.1001/jama.2015.14905