Study shows African American men face greater risk for advanced disease compared with Caucasian men
In a study involving African American men who were considered to have a low-risk prostate cancer upon initial consultation, researchers discovered that, when a radical prostatectomy was performed, the incidence of advanced-stage cancer was nearly twice that of Caucasian men. Thus, more rigid criteria may be required for African American men with prostate cancer contemplating active surveillance of the disease.
Using data from men who underwent a radical prostatectomy between 1997 and 2011 at The Cancer Institute of New Jersey and Johns Hopkins medical institutions, researchers performed a retrospective analysis. Of 1536 African American men, 196 met University of California San Francisco (UCSF) eligibility guidelines for active surveillance, and a smaller group of 124 African American men met the eligibility criteria of the National Comprehensive Cancer Network (NCCN) guidelines. Of 608 Caucasian men, 191 and 143 met UCSF and NCCN guideline eligibility criteria, respectively.
Although the rate of higher-grade prostate cancer in the African American men first categorized with very low-risk prostate cancer was slightly higher (37.2%-46.0%), it was not significantly different from the Caucasian men (33.5%-39.2%). However, the risk of advanced-stage prostate cancer was nearly twice as high in blacks as in whites, 19.4% and 10.1%, respectively. Therefore, among those categorized prior to surgery with low-risk disease, blacks are twice as likely to actually have advanced prostate cancer.
Isaac Yi Kim, MD, PhD, chief of the Section of Urologic Oncology at The Cancer Institute of New Jersey, associate professor of surgery at UMDNJ-Robert Wood Johnson Medical School, and senior author of the study said, “Considering these higher incidences of more advanced prostate cancer in African American men, our findings suggest that more stringent criteria may be needed for those in this population who are considering active surveillance.”
Study results are available in the latest online issue of Urology.
Source: CINJ.