961: Prostate Cancer Screening and Detection in Inner-City Men
Open accessAbstract
INTRODUCTION AND OBJECTIVE:The prognostic implications of racelethnicity in prostate cancer remains somewhat controversial.African-American (AA) men have been shown to have poorer overall outcomes , but whether this is due to race itself or other surrogates for ethnicity remains unclear.Given the overall improvement in biochemical recurrence (BCR) rates in recent years, we elected to revisit t~e iss~e of pros~ate cancer outcomes after radical prostatectomy (RP) 1n Afncan-Amencan men since the onset of the PSA era.METHODS: 2,464 patients from the Duke Prostate Center database underwent RP from 1988-2004, of which 294 were AA and 2169 were non-AA.Based on surgery date, patients were divided into 3 treatment periods: 1: 1988-1996; 2: 1997-2000; and 3:2001-2004.Diagnostic PSA (dxPSA), diagnostic Gleason sum (dxG), clinical T stage (cT), pathological Gleason sum (pG), pathological T stage (pT), margin status and BCR were compared between AA and non-AA in each of the 3 treatment periods using univariate and multivariate analyses.. . . . .RESULTS: In treatment period 1, AA men had a s1gmf1cant Increase 1n dxPSA (p = 0.02), pG (p = 0.003), and margin status (p = 0.006) compared with the non-AA group.In treatment period 2, the AA group had a significant increase in cT stage (p = 0.03), dxG (p = 0.01 ), and pG (p = 0.04).In treatment period 3, the AA group had a higher pG (p = 0.006).Kaplan-Meier survival analysis showed a significantly increased risk of BCR for AA men in period 1 and 2. In period 3, a trend towards higher BCR probability was seen in AA men, but not at a statistically significant level (p > 0.05).Cox model showed a significant role of race on BCR in period 2.CONCLUSIONS: The univariate analysis shows that from the beginning of the PSA era to present, race remains a poor prognostic factor.AA men have higher tumor burden and poorer overall outcome when compared with the non-AA group.However, race as an independent prognostic factor was only seen in treatment period 2 based on the multivariate analysis, indicating longer follow-up is needed.
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Black men are more likely to be diagnosed with metastatic disease (stage IV).
“Black men are also more likely to be diagnosed with metastatic disease (stage IV) [5] for which the 5-year survival rate drops to 30% [1], and black men are 2.4 times more likely to die from PC compared with NHW men [3].”
From Brief report of a tablet-delivered psychosocial intervention for men with advanced prostate cancer: Acceptability and efficacy by race (2019) · cites this paper as [5]
The Results (abstract; page unavailable) report that African American men in this inner-city cohort more often had advanced disease or distant metastasis than the comparison groups (16.1% versus 3.8% and 0%). The paper combines T3/T4, N1, and M1 cases, so it does not establish a higher rate specifically of metastatic (stage IV) diagnoses. (LLM, conf=0.88)
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Bouchard, L. C., Yanez, B., Dahn, J. R., Flury, S. C., Perry, K. T., Mohr, D. C., & Penedo, F. J. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/iby089 · Cited by 24 · see citing works
- Authors
- Anai, S., Wludyka, P., Pendleton, J. M., Williams, C., Nelms, L., Pettaway, C. A., & Rosser, C. J.
- Venue
- Journal of Urology
- Published
- 2006-04
- Volume
- 175
- Issue
- 4S
- Pages
- 310-310
- ISSN
- 0022-5347 (ISSN-L)
- 1527-3792
- OpenAlex
- W2791981607
- Cited by
- 1
- References
- 0
- Type
- conference abstract
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Urology (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- prostate cancer, African American men, racial disparities, biochemical recurrence, radical prostatectomy, prostate-specific antigen, Gleason score, tumor burden, prostate cancer screening, prostate cancer outcomes, ethnic differences in cancer outcomes, prostate cancer detection
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