Race, ethnicity and benign prostatic hyperplasia in the health professionals follow-up study

Purpose: We examined whether the prevalence of benign prostatic hyperplasia (BPH) varies by racial or ethnic origin in a large cohort of American male health professionals. Materials and Methods: Included in our study were 1,508 men who underwent s urgery for BPH between 1986 and 1994, and 1,837 with high moderate to sever e lower urinary tract symptoms assessed by the American Urological Associat ion symptom index in 1992 or 1994. "Noncases" comprised 23,246 asymptomatic participants. Self-reported major ancestry was black in 201 men, Asian in 413, other origin in 604 and white in 25,373. White heritage was further cl assified as southern European in 6,408 men, Scandinavian in 2,951 and other white in 16,014. The relative risk of BPH and 95% confidence intervals (CI ) adjusted for age, body mass index, alcohol consumption, smoking and physi cal activity were calculated by logistic regression. Results: Black men were not at increased risk for BPH (relative risk 0.85, 95% CI 0.55 to 1.31) compared with white men. Asian men were less likely to have undergone BPH surgery (relative risk 0.41, 95% CI 0.21 to 0.82), alth ough the relative risk for symptoms was similar to that of white men. White men whose major ancestry was southern European were at modestly higher ris k for BPH surgery (relative risk 1.28, 95% CI 1.12 to 1.46) and symptoms (r elative risk 1.34, 95% CI 1.20 to 1.50), whereas men of Scandinavian herita ge were at slightly decreased risk for symptoms than those of other white h eritages. Conclusions: Racial and ethnic variation is evident in the incidence of BPH surgery and symptom severity. Whether this observed variation reflects und erlying biological phenomena rather than differences in symptom tolerance r equires further exploration.