The prevalence of prostate cancer in Brazil is higher in Black men than in White men: Systematicreview and meta-analysis

Abstract

Background: Black men have a higher incidence of prostate cancer compared with White men in several countries. In Brazil, most studies reported a similar prevalence of prostate cancer between Blacks and Whites as a result of the high race mixture of the population. Objective: To perform a systematic review with meta-analysis of the prevalence of prostate cancer in Black versus White, Brown versusWhite, and Black versus Brown Brazilian men. Design, Setting, and Participants: This systematic review included cohort, cross sectional and case-control studies comparing the prevalence of prostate cancer between races in Brazil. It was performed using an electronic search of references in bibliographic databases, and dissertations and theses databases from several Brazilian hospitals, universities, and schools of medicine. Meta-analysis was conducted using the RevMan software from the Cochrane Collaboration. To control for potential confounding variables, sensitivity analyses excluding case-controland cross sectional studies were performed. Measurements: The outcomes of interest included the number of participants, prevalence of prostate cancer, and odds ratio of cancer between Black and White men, Brown and White men, and Black and Brown men. Results and Limitations: : Twelve studies approaching the prevalence of prostate cancer in Black or Brown vs. White men in Brazil were identifi ed, totalizing 41388 participants. The prevalence of prostate cancer was 9.6% in Black vs. 5.6% in White men (OR 1.58), 10.1% in Black vs. 6.7% in Brown men (OR 1.43), and 6.7% in Brown vs. 6.6% in White men (OR1.14). Limitations of this review refl ect the complexity and ambiguity in the defi nition of who is Black and who is not in such an heterogeneous population like the Brazilian people. Conclusions: Thissystematic review with meta-analysis demonstrates a higher prevalence of prostate cancer in Black mencompared to White or Brown Brazilian men. The prevalence of prostate cancer is similar in Brown versus White men.