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Prostate cancer has a huge and growing burden of disease, yet its natural history has not been fully elucidated. Several studies have shown a positive association between IGF-1 and prostate cancer, suggesting that perhaps increased levels of this hormone could be considered a risk factor for the disease. The ProCEED study was undertaken to examine whether levels of serum IGF-1 were higher in prostate cancer patients vs patients without prostate cancer. Prostate cancer cases and non-cancer controls were recruited in a Veteran s Administration general urology clinic setting. Clinical / sociodemographic data and blood draws for ascertainment of laboratory assays were collected during the study visit and by reviewing medical records. Only African-American and Caucasian men over the age of 50 who lived in the state of Illinois were included in the study. Patients were classified as prostate cancer cases if they had recent biopsyproven adenocarcinoma. Controls were required to have a negative digital rectal exam at the study visit, no history of BPH or prostate cancer, and two normal PSA values (one within one year of study entry). Univariate group means were compared using t-tests or Cochran Mantel-Haenszel tests as appropriate. Multivariable analysis was performed using logistic regression methods, with prostate cancer status as the dependent variable., The original document contains color images.

Prostate cancer has a huge and growing burden of disease, yet its natural history has not been fully elucidated. Further, it is unknown why African American men have the highest incidence rates in the world. The overall goals of the ProCEED pilot study are as follows: (1) to advance understanding of the IGF axis and its interplay with race/genetics and dietary/lifestyle risk factors for prostate cancer, (2) to elucidate modifiable risk factors that interact with genetics and possibly lead to a greater incidence of prostate cancer among African Americans, and (3) to disseminate learned information in an effort to prevent disease. It is hypothesized that racial differences in prostate cancer risk are attributed, in part, to interactions between lifestyle factors and the IGF axis. This study attempts to elucidate dietary and lifestyle risk factors which may operate/interact uniquely in African Americans. If there are lifestyle risk factors for prostate cancer that can be modified, this would be valuable information for primary and perhaps secondary prevention of prostate cancer. The fourth year of the grant was dedicated to the completion of subject enrollment and the beginning of the data analysis phase of the project. At the end of the enrollment period there were 87 subjects enrolled into the study (57 prostate cancer cases and 30 controls). A no-cost extension has been requested to process the lab samples and finish the study in 2010. Data management activities, dietary data analysis, laboratory sample processing, and study data entry are currently underway. No final results from this study are yet available., The original document contains color images.

The third year of the grant was dedicated to continued subject enrollment. At the end of the enrollment period there were 87 subjects enrolled into the study (57 prostate cancer cases and 30 controls). A no-cost extension was recently obtained in order to complete study in 2009. Data management activities, dietary data analysis, laboratory sample processing, and study data entry are currently underway. No final results from this study are yet available.

The second year (2007) of ProCEED study funding was dedicated to subject enrollment. Interim results are available for most parameters except those that were planned to be analyzed at study end. At the end of the reporting period, there were 62 patients enrolled (56 prostate cancer cases and 6 controls). Among the 62 patients there was a 79% subject retention rate for the dietary follow-up calls. Interim analyses indicate that the study sample thus far is elderly, obese, and predominantly African-American. Among the prostate cancer cases most of the cases were diagnosed in stage T2 and had Gleason scores of 7 or less. The most frequently used prostate cancer treatment was hormonal therapy. The third year (2008) of funding will be dedicated to: continued subject enrollment, dietary analyses, laboratory assays, statistical analysis, and a written summary., The original document contains color images.

As the first year of the grant was dedicated to study start-up activities, no results from the main study are yet available. A descriptive epidemiology study comparing racial trends in prostate cancer incidence rates in Illinois and the United States was undertaken. The objective of this study was to examine trends in Illinois and US prostate cancer rates to ascertain whether trends were similar by race. Incidence rates were obtained from Illinois State Cancer Registry and SEER. Rate ratios were estimated for three periods: 1986-1990 ("pre-PSA"), 1991-1995 ("PSA-uptake"), and 1996-2000 ("PSA-widespread use"). Incidence rates peaked in the mid-i 1990s. Rate differences between the two regions narrowed in 1994 and 1995. African- Americans had higher incidence rates than Caucasians throughout. The post-1996 incidence pattern in Illinois, however, was unique with the incidence rates in African-Americans declining and the racial disparities narrowing. This suggests more effective prostate cancer screening is taking place in Illinois African-American populations than US African-American populations, although differential risk profiles may also be operating., The original document contains color images.