Race Differences in Telomere Length in Benign Prostate Biopsies and Subsequent Risk of Prostate Cancer

Background: Telomere shortening is linked to aging and may be associated with increased risk for cancer. Most cancer studies have used telomere length in leukocytes rather than in the target tissue of cancer origin. Methods: A case-control study of 524 case-control pairs with a benign prostate biopsy nested within a historical cohort of 10,478 men was conducted to determine whether premalignant prostate telomere length (assessed using a modified qRT-PCR) is associated with prostate cancer risk. Results: Telomere lengths in benign prostate biopsies of cases versus controls were similar (1.46 +/- 0.38 vs. 1.45 +/- 0.42; P = 0.49). African American (AA) men had significantly shorter telomeres compared with White men (1.51 +/- 0.38 vs. 1.63 +/- 0.39; P < 0.0001). In race-stratified analyses, increasing telomere length was more strongly associated with prostate cancer risk in White men, wherein those with telomere length in the highest quartile had 1.9-fold greater adjusted risk of prostate cancer compared with men with prostate telomere lengths in the lowest quartile [OR = 1.90; 95% confidence interval (CI) = 1.08-3.36]. Men in the highest telomere length quartile also had a greater risk of aggressive prostate cancer compared with men with telomere lengths in the lowest quartile (OR = 2.78; 95% CI = 1.25-6.19). Conclusions: White men have longer telomeres in benign pros-tate tissue compared with AA men, and those with the longest telomeres may be at increased risk for prostate cancer, particularly the more aggressive form of the disease. Impact: Race-specific telomere length measures may be an early biomarker of aggressive prostate cancer.