Metabolomics of Menthol Cigarette Smoking and Risk for Aggressive Prostate Cancer Among African American Men
Abstract
African-American (AA) men have a remarkable higher risk of developing and dying from more deadly prostate cancer (PCa) than European American (EA) men. However, this racial health disparity cannot be fully explained by screening and access to treatment, and genetics can only partially explain the disparity that does little for AA men to identify and prevent the disease early. Currently, there are only three risk factors—age, race, and family history of PCa—have been definitively identified. Although cigarette smoking has not yet defined as a confirmed risk factor for PCa, more and more evidence from larger studies have shown clearer evidence of a higher risk of dying and the development of a secondary cancer among current smokers, presenting an urgent need in research, since cigarette smoking is preventable, but has not been emphasized in PCa prevention. Previous studies have shown that AA smokers have higher nicotine concentrations in the body than EA smokers, even when smoking fewer cigarettes per day, highlighting the fact that self-reported cigarettes used predicts the actual amount of smoke inhaled to the body more poorly in AAs than in EAs. Approximately 90% of AA smokers use menthol cigarettes. Menthol provides a cooling sensory effect to reduce the harshness of cigarette smoke and has been linked with higher rates of addiction, resulting in inhaling smoke deeper, and keeping cancer-causing agents in the body longer. Unfortunately, most studies that used questionnaires rely on the participants to report smoking-related questions by themselves, and are unable to measure the smoking intensity and the volume of puffing. This generates issues, particularly of socially undesirable behaviors or among newly diagnosed cancer patients, and can underestimate the usage. Therefore, how smoking increases the risk of PCa should be re-evaluated using more objective and innovative methods together with self-reported data. The disparities in smoking behaviors between AA and EA men and the relationship to the deadly type of PCa have never been carefully studied, presenting a gap in knowledge and missed opportunity to address this PCa racial disparity. Here, we plan to use data and blood samples from an existing large study that includes only prostate cancer patients (the North Carolina–Louisiana Prostate Cancer Project [PCaP]) from two southern states, where there are significant racial disparities in PCa, to address the PCRP Health Disparity Research Award focus area of environmental factors contributing to the disparity of lethal PCa in AAs by identifying smoking-related metabolite patterns that are linked with highly deadly PCa in AAs compared to EAs. From our preliminary findings on the PCaP data, we found that there were more AAs and more current smokers that were diagnosed with deadly (high aggressive) PCa. Current smokers had a 2.4-time higher risk of having deadly PCa; when we looked at data separately by race, the risk disappeared for EAs but increased for AAs. We hypothesize that AA menthol cigarette smokers inhaled deeper and absorbed more smoke from each cigarette, leading to more aggressive PCa. An innovative technology will be used to measure thousands of metabolite profiles in blood, including metabolites of nicotine and menthol, to understand the metabolic impact from smoking. Those data will be used to create risk models to understand the link of cigarette use and PCa severity among AAs and EAs. Since some prostate cancers grow slowly that never cause problems for a PCa patient, those that are aggressive PCa should be the focus when examining the relationship on the exposure of cancer-causing agents. Thus, this study will include only subjects with high or low PCa aggressiveness in which men with more deadly PCa will be considered “cases,” and men with low PCa aggressiveness (PCa that causes little harm) will be considered “controls” to focus on finding markers for more deadly PCa. Our study is h
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110226
Entities
People
- Ping-Ching Hsu
Organizations
- United States Army
- University of Arkansas for Medical Sciences