Risk factors for high-grade prostate cancer in an inner-city population: Analysis of commonly dispensed medications and patient comorbidities.

Abstract

e17080 Background: The purpose of this study was to determine risk factors for having high-grade prostate cancer at biopsy by analyzing commonly dispensed medications and patient comorbidities. Methods: This was a retrospective chart review of an inner-city demographic. Patients who had their biopsy performed at Kings County Hospital from 2018 to 2024 were included if their first biopsy during this period showed adenocarcinoma. Demographics along with past medical history on common comorbidities and their subsequent medications were identified and analyzed. Lastly, prostate-specific antigen value (PSA) that preceded the biopsy (within 3 months) and Gleason Score were also included. To determine differences between the very high-grade cancer group and the rest of the cohort, comparisons were made using chi-square tests for categorical variables and independent sample t-tests for continuous variables. Levene’s test was used to confirm equal variance of continuous variables if this resulted in a significant value, then a Welch’s t-test was performed instead. Subsequently, a logistic regression was performed to derive odds ratios where higher odds indicate increased risk at higher grade cancer. Results: This study included 302 patients with an average age of 66.3 ± 7.4 years. The study included primary Black/African American individuals (N = 282, 93.4%). From a total of 302 patients, 16.9% (N = 51) had a Gleason Score of 9 or 10. A summary comparing variables from this group to patients with lower Gleason Scores is shown in Table 1. Logistic regression log odds are summarized in Table 1. Log of PSA values had an odds ratio of 3.18 [2.25, 4.49] and beta-blocker use was also significantly associated with a greater risk of very high-grade cancer with an odds ratio of 7.11 [2.12, 23.78] when adjusted for all other variables. No other tested variable showed significant results. Conclusions: This study shows that lifetime use of beta-blockers may be a risk factor for high-grade prostate cancer amidst a slew of commonly administered medications and patient comorbidities in an underserved patient population. Variable Gleason Score ≤ 8(N = 251) Gleason Score ≥ 9(N = 51) P Value χ2/ t tests Odds Ratio[95% CI] P Value Odds Ratio Age 65.8 ± 7.2 68.8 ± 8.0 0.01 1.03 [0.97-1.09] 0.109 PSA 31.8 ± 86.2 414.6 ± 702.3 < 0.001 3.18 [2.24-4.49] <0.001 ACE Inhibitor 56 (22%) 15 (29%) 0.28 2.54 [0.86-7.48] 0.214 Beta Blocker 28 (11%) 12 (24%) 0.017 7.11 [2.12-23.78] 0.005 Insulin 28 (11%) 5 (10%) 0.78 0.56 [0.10-3.19] 0.913 Metformin 50 (20%) 6 (12%) 0.17 0.24 [0.04-1.28] 0.229 Statins 130 (52%) 18 (35%) 0.032 0.45 [0.12-1.62] 0.123 Diabetes 83 (33%) 15 (29%) 0.61 1.09 [0.31-3.81] 0.873 Heart Failure 11 (4%) 4 (8%) 0.30 1.87 [0.37-9.41] 0.565 Hyperlipidemia 119 (47%) 21 (41%) 0.42 1.81 [0.55-5.94] 0.455 Hypertension 177 (71%) 33 (65%) 0.41 0.47 [0.17-1.33] 0.337 Smoker 55 (22%) 13 (25%) 0.58 2.17 [0.80-5.85] 0.313