Race and socioeconomic status are independently associated with benign prostatic hyperplasia.

Fowke JH, Murff HJ, Signorello LB, Lund L, Blot WJ
J Urol. 2008 180 (5): 2091-6; discussion 2096

PMID: 18804231 · PMCID: PMC2692430 · DOI:10.1016/j.juro.2008.07.059

PURPOSE - Prostate enlargement is common as men age. However, differences in the diagnosis or treatment of clinical benign prostatic hyperplasia between black and white men remain poorly understood. We investigated racial differences in and surgical intervention for benign prostatic hyperplasia in a large and predominantly low income population.

MATERIALS AND METHODS - Participants included 21,949 men, of whom 79.8% were black and 20.2% were white, recruited from 60 community health centers in the southeastern United States between 2002 and 2007. Benign prostatic hyperplasia, surgical intervention for benign prostatic hyperplasia, and economic and demographic indexes, eg education, household income, health insurance and marital status, were determined by an interview in person. Logistic regression was used to summarize the association between race and benign prostatic hyperplasia while controlling for health care access and socioeconomic status.

RESULTS - Black men were approximately half as likely to report a benign prostatic hyperplasia diagnosis compared to white men (4.1% vs 9.9%, age adjusted OR 0.45, 95% CI 0.40, 0.51), a difference that persisted with only small abatement after controlling for age, income, insurance coverage, comorbidity, education and other factors (adjusted OR 0.49, 95% CI 0.43, 0.56)). Of men with benign prostatic hyperplasia surgical intervention for that condition (133 patients) was more prevalent in black vs white men (12.9% vs 9.1%, adjusted OR 1.65, 95% CI 1.10, 2.48).

CONCLUSIONS - After controlling for economic factors associated with benign prostatic hyperplasia black men were significantly less likely to report a prior benign prostatic hyperplasia diagnosis. In contrast, surgical intervention typically reserved for severe benign prostatic hyperplasia was more common in black men. Our results suggest that race and socioeconomic status are independently associated with benign prostatic hyperplasia.

MeSH Terms (23)

Adult African Americans Aged Aged, 80 and over Age Distribution Attitude to Health Confidence Intervals Cross-Sectional Studies European Continental Ancestry Group Humans Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Prevalence Prostatic Hyperplasia Risk Factors Severity of Illness Index Socioeconomic Factors Surveys and Questionnaires Transurethral Resection of Prostate United States

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