8265508 Serum organochlorine insecticide concentrations and risk of aggressive prostate cancer

<h3>Objective</h3> Prostate cancer is one of the leading causes of cancer morbidity and mortality among men worldwide, with heightened rates in Africa and the Caribbean. Although few risk factors have been identified, studies have shown positive associations with exposure to persistent organochlorine pesticides (OCPs) and aggressive prostate cancer. Few studies have studied OCPs in Africa despite continued exposure and the high burden of prostate cancer. Here we described predictors of serum levels of OCPs in 300 prostate cancer cases (within 1-yr of diagnosis) and 300 population-based controls enrolled in the great Accra region of Ghana (2004-2012). <h3>Material and Methods</h3> Serum concentrations of three DDT (dichlorodiphenyltrichloroethane) metabolites were measured: pp’-DDE, pp’-DDT, op’-DDT. Chi-Square tests were used to examine the relationship between DDT and demographic/lifestyle factors in controls. Levels were reported in cancer cases by clinical factors, including high-grade (Gleason≥8) and advanced stage (T3 or T4) disease. <h3>Results</h3> Among 300 controls, the geometric means (and percent detected) of pp’-DDE, pp’-DDT, and op’-DDT were at 737.6 ng/g-lipid (99.7% detect), 48.4 ng/g-lipid (95.6% detect), and 16.7 ng/g-lipid (45.3% detect), respectively. Increasing BMI was associated with higher serum levels of pp’-DDE and pp’-DDT (chi-square p-value=0.064 and 0.002, respectively). In cases, higher mean levels of pp’-DDE were observed in men with high-grade compared to low-grade disease (1109.3 ng/g-lipid vs. 760.4 ng/g-lipid, p-value=0.038) and in men with advanced disease (1139.2 ng/g-lipid vs. 838.7 ng/g-lipid, p=value=0.028). Measurable levels of DDT were abundant in serum samples in men from Ghana (pp’-DDE=737.6 ng/g-lipid vs. 262 ng/g-lipid and nondetectable op’-DDT in Black men in the U.S.), suggesting ongoing exposure. <h3>Conclusions</h3> Consistent with reports that DDT is highly fat soluble, higher BMI was associated with higher serum concentrations. Serum levels of pp’-DDE were higher for those with aggressive prostate cancer, offering evidence of a plausible link between exposure and aggressive prostate cancer risk in Africa.