Prostate cancer (PC) is the principal malignancy affecting African descent men in the Caribbean and the USA. Disparities in incidence, prevalence, and mortality in these populations are poorly understood. We evaluated the urologic characteristics and sexual behaviors of men with histologically confirmed PC (cases) and age-matched controls in the nationwide Prostate Cancer in a Black Population (PCBP) study conducted in Barbados. Cases were around 1.5 to 3 times more likely to report symptoms of prostatic enlargement, hematuria/hematospermia, and previous prostatitis. Sexually transmitted infections (STIs) were similar among cases (24.5%) and controls (26.7%). First sexual intercourse before the age of 16 was associated with an increased likelihood of both low- (Gleason score < 7; OR 1.63; 95% CI: 1.03–1.66) and high-grade PC (Gleason score ≥ 7; OR 1.82; 1.11–2.99). PC risk decreased with later age of sexual debut ( ). More lifetime sexual partners was associated with increased odds of high grade PC ( ). The contribution of sexual behaviors to the development and the outcomes of PC is likely due to multiple mechanisms, and further study will be necessary to elucidate the underlying pathophysiologic mechanisms in this and similar populations. 1. Introduction Prostate cancer (PC) rates and mortality are highest among African American men globally [1]. PC is also the most frequent malignancy affecting African-Caribbean men [2–5], a group which shares a common heredity with African Americans as a historical consequence of the West African slave trade. The reasons for the high PC risk and poor outcomes in African-derived populations remain unknown and are likely multifactorial. Among environmental factors associated with PC, various investigators have described associations between increased PC risk and sexual behaviors [6–8]. In spite of the high burden of PC in the Caribbean, there are few data on disease manifestations or environmental risk factors, particularly sexual behaviors [9, 10]. While some urologic signs and symptoms are commonly observed among persons with PC, this information remains largely unreported in African-Caribbean populations. This paper describes urologic characteristics of men diagnosed with prostate cancer and presents new information about sexual behaviors and PC risk in a national case-control study conducted in Barbados, West Indies. 2. Materials and Methods 2.1. Study Population The Prostate Cancer in a Black Population (PCBP) study was a nationwide case-control study of Barbadian men with histologically confirmed newly diagnosed
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