Prostate Cancer Clinical Trial
Official title:
Survey of Prostate Cancer in Accra, Ghana
This study, conducted at Korle-Bu Hospital in Accra, Ghana, will help elucidate the roles of
lifestyle and genetic factors in prostate cancer risk. There is a strong variation in risk of
prostate cancer throughout the world. The rates of the disease among African Americans are
some of the world s highest. In the United States, the incidence of prostate cancer is 70
percent higher in African Americans than in white Americans and the death rate in African
Americans is almost double that of white Americans. The reasons for this excessive risk are
unknown, but both genetic and lifestyle factors have been suggested.
Because Africans and African Americans share similar genetic ancestry but have vastly
different lifestyles, a better understanding of the rates and risk factor profiles for
prostate cancer among Africans will provide important clues to what causes the disease. This
study will try to assess the incidence of prostate cancer in the West African nation of
Ghana. The study has two components:
- Clinical survey The methods of diagnosis at Korle-Bu will be evaluated and the incidence
of prostate cancer over a 5-year period will be estimated.
- Screening and detection survey A survey of 1,000 men between 50 and 74 years of age will
estimate the prevalence of both asymptomatic and undiagnosed symptomatic prostate cancer
in the Accra population.
The clinical survey will use data from the cancer logbook and medical records at Korle-Bu
Hospital and the Ghanaian National Census to derive an estimate of prostate cancer incidence
within Accra. The estimate will be low, since it will be based only on men diagnosed or
treated at Korle-Bu and will not include men with asymptomatic disease, men diagnosed
elsewhere, or men without access to medical care. The screening and detection survey will
assess the presence of asymptomatic and unrecognized symptomatic prostate cancer using PSA
testing and digital rectal examination in a random sample of 1,000 men in the general
population of Accra. This will provide a high estimate of disease prevalence. The two
estimates will provide an approximation of the true incidence rate of the disease in Accra.
Comparison of these data with similar data from community surveys of African Americans will
provide insight into reasons for the excess risk of prostate cancer in African Americans.
OBJECTIVE: The key aim of this study is to assess the burden of prostate cancer in Ghana and to evaluate how the impact of prostate cancer among West Africans compares with that among African Americans, whose reported incidence rates are among the highest in the world. West Africans and African Americans share genetic ancestry but have very different lifestyles and environmental exposures. The study aim will be achieved by establishing lower and upper bounds on the true incidence of prostate cancer in the capital city of Accra. The secondary aim of the study is to establish epidemiological, biochemical, and genetic profiles of West Africans for comparisons with African Americans to provide etiologic clues for prostate cancer. DESIGN: The study will consist of two components: 1. a clinical survey, a. divided into a five-year retrospective, and b. a 3-year prospective phase, and 2. a population screening survey. ;
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