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APHA Scientific Session and Event Listing

Katrine Wallace, MA, ABD¹, Sylvia Furner, PhD², Vincent Freeman, MD, MPH², and Faith Davis, PhD². (1) Institute for Research on Health and Aging, University of Illinois at Chicago, 1747 W Roosevelt Road, MC 275, Chicago, IL 60608, 312-413-8825, kwalla2@uic.edu, (2) School of Public Health - Epidemiology & Biostatistics, University of Illinois at Chicago, 1601-3 W Taylor St, MC 923, Chicago, IL 60612

The introduction of PSA screening in 1988 may have led to the observed increase and subsequent decrease in US prostate cancer incidence. The objective of this study was to examine Illinois and US prostate cancer rates from 1986-2000, by race, to ascertain whether trends are similar.

Incidence rates by race for 1986-2000 were obtained from IL State Cancer Registry and SEER. Indirect standardization was performed for three periods: 1986-1990 (“pre-PSA”, before routine screening), 1991-1995 (“PSA-uptake”), and 1996-2000 (“PSA-widespread use”). SIRs and 95% CIs were calculated.

Incidence rates were stable during pre-PSA, with SIRs of 0.78(0.77-0.79) for Caucasians and 0.75(0.72-0.77) for African-Americans. During PSA-uptake, rates among all Caucasians and US African-Americans increased and decreased in parallel. However, IL African-Americans demonstrated a slower increase/decrease over time. SIRs during PSA-uptake were: 0.83(0.82-0.84) for Caucasians and 0.71(0.69-0.73) for African-Americans. The SIRs for Caucasians increased while SIRs for African-Americans decreased between pre-PSA and PSA-uptake periods. During PSA-widespread use, rates re-stabilized, with IL African-American rates stabilizing latest. SIRs during PSA-widespread use were: 0.88(0.87-0.89) for Caucasians and 0.81(0.79-0.83) for African-Americans. Incidence differences between African-Africans and Caucasians widened from 1986-2000.

Rate differences between IL and US Caucasians diminished over time, per the SIRs and narrowing incidence rates. US African-Americans presented similarly to Caucasians, albeit with higher rates. The incidence pattern in IL African-Americans, however, was unique. All SIRs reflected lower-than-expected incidence for IL. Racial disparities increased between “pre-PSA” and “PSA-widespread use”. While rate differences noted here could be due to screening, other potential causes should be investigated.

Learning Objectives:

At the conclusion of this presentation, audience members will have learned about prostate cancer incidence patterns in Illinois (1986-200
• compared with the US. Also, health department personnel will have learned how to generate sandardized incidence ratios (SIRs) using population data, regional cancer data, and national rates from SEER*stat

Keywords: Epidemiology, Cancer

Presenting author's disclosure statement:

Not Answered