Development, Evaluation, and Implementation of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the Prostate

Abstract

Purpose: Cancer of the prostate (CaP) is the leading cancer among men in sub-Saharan Africa (SSA). A substantial proportion of these men with CaP are diagnosed at late (usually incurable) stages, yet little is known about the etiology of CaP in SSA.

Methods: We established the Men of African Descent and Carcinoma of the Prostate Network, which includes seven SSA centers partnering with five US centers to study the genetics and epidemiology of CaP in SSA. We developed common data elements and instruments, regulatory infrastructure, and biosample collection, processing, and shipping protocols. We tested this infrastructure by collecting epidemiologic, medical record, and genomic data from a total of 311 patients with CaP and 218 matched controls recruited at the seven SSA centers. We extracted genomic DNA from whole blood, buffy coat, or buccal swabs from 265 participants and shipped it to the Center for Inherited Disease Research (Baltimore, MD) and the Centre for Proteomics and Genomics Research (Cape Town, South Africa), where genotypes were generated using the UK Biobank Axiom Array.

Results: We used common instruments for data collection and entered data into the shared database. Double-entered data from pilot participants showed a 95% to 98% concordance rate, suggesting that data can be collected, entered, and stored with a high degree of accuracy. Genotypes were obtained from 95% of tested DNA samples (100% from blood-derived DNA samples) with high concordance across laboratories.

Conclusion: We provide approaches that can produce high-quality epidemiologic and genomic data in multicenter studies of cancer in SSA.

Fig 1

Men of African Descent and Carcinoma of the Prostate (MADCaP) organizational and collaborative structure. African centers (blue circles) include 37 Military Hospital (37MIL), Accra, Ghana; Stellenbosch University and Tygerberg Hospital (CPT), Cape Town, South Africa; Institut de Formation et de la Recherche en Urologie (IFRU), Dakar, Senegal; Wits Health Consortium and National Health Laboratory Service (JNB), Johannesburg, South Africa; Korle-Bu Teaching Hospital (KBTH), Accra, Ghana; University of Abuja Teaching Hospital (UATH), Abuja, Nigeria; and University College Hospital (UCH), Ibadan, Nigeria. US partner institutions (orange circles) include Albert Einstein College of Medicine (AECM), Bronx, New York; Columbia University (CU), New York, New York; Dana-Farber Cancer Institute (DFCI), Boston, Massachusetts; Georgia Institute of Technology (GT), Atlanta, Georgia; and Stanford University (SU), Palo Alto, California. Central resource facilities (green circles) include the Centre for Proteomics and Genomics Research (CPGR), Cape Town, South Africa, and DFCI. Other collaborating MADCaP partners include the Center for Inherited Disease Research (CIDR) and the Intramural Program of the National Cancer Institute (NCI).

Fig 2

Men of African Descent and Carcinoma of the Prostate study schema separated into the enrollment and postenrollment processes. QC, quality control.

Fig 3

Results of genotype analyses of study samples. (A) Success rate of samples assayed on the Axiom Array. (B) Results of principal components analysis to evaluate genomic ancestral population groups where different colors represent different population groups; orange represents African, blue represents admixed, and green represents European. Eigenvalues indicates the amount of variation in the sample data. Eigenvectors are the linear combinations showing how variables contribute to each axis. CIDR, Center for Inherited Disease Research; CPGR, Centre for Proteomics and Genomics Research; QC, quality control.