Abstract
Objectives
To determine the magnitude of racial disparity in lower urinary tract symptom (LUTS)
severity and bother by combining two large comparable epidemiologic studies of community-dwelling
white and black men, thereby avoiding many of the referral biases present in previous
studies. Prior studies evaluating racial differences in benign prostatic hyperplasia
have been hampered by selection bias, because nearly all have used surgical treatment
as a marker for benign prostatic hyperplasia.
Methods
Data from the Olmsted County Study of Urinary Symptoms and Health Status and the Flint
Men’s Health Study were combined for a total study sample of 2480 men. We examined
LUTS severity and associated bother as measured by the self-administered American
Urological Association Symptom Index and Symptom Problem Index.
Results
Overall 34% of white men reported moderate/severe LUTS compared with 41% of black
men (P <0.001). These patterns were consistent across age and persisted after adjustment
for age and other sociodemographic factors. The relationship between LUTS severity
and bother differed by race in that black men reported less bother for each unit increase
in LUTS (P <0.001).
Conclusions
In contrast to studies based on clinical populations, our community-based study demonstrated
greater LUTS severity in black men compared with white men but black men reported
less bother for any given level of LUTS severity. Although these findings suggest
a racial disparity in benign prostatic hyperplasia, additional studies of anatomic,
physiologic, and molecular factors may clarify whether these racial differences are
real or due to sociocultural differences in reporting symptom morbidity.
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Article info
Publication history
Accepted:
February 13,
2003
Received:
January 14,
2003
Footnotes
☆This study was funded, in part, by research grants from Merck Research Laboratories as part of the BPH Natural History Study Group and the Public Health Service, National Institutes of Health grants AR30582, DK58859, and P50CA69568.
Identification
Copyright
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
