(UroToday.com) The 2022 Southeastern Section of the AUA’s annual meeting included a prostate cancer session and Dr. Aaron Bradshaw discussing a potential association of family history of prostate cancer and differences in oncologic outcomes for African American and Caucasian men. Prostate cancer outcomes generally differ between Caucasian and African American populations. However, it is unknown whether a positive family history of prostate cancer has a similar effect on oncologic outcomes in each population. The objective of this study was to compare the impact of family history on prostate cancer outcomes in African American and Caucasian men.
Dr. Bradshaw and colleagues completed a retrospective analysis of 266 consecutive African American men with clinically localized prostate cancer who underwent robotic radical prostatectomy. For comparison, they also abstracted 250 consecutive Caucasian men who also underwent robotic radical prostatectomy. Cohorts were subdivided for analysis into those with or without a family history of prostate cancer. Family history was classified as a first degree relative with prostate cancer and was determined at diagnosis. Clinical and demographic variables were obtained via chart review. Two sets of comparative analyses were performed in parallel: men with a positive family history of cancer, and men without. Primary outcomes were differences in post-operative PSA and rate of upgrading/upstaging between Caucasian and African American populations.
A similar proportion of Caucasian (65/250) and African American groups (63/246) were found to have a significant family history of prostate cancer. After grouping by family history, African American were found to be younger at diagnosis (p < 0.01) and have longer follow-up on average (p < 0.01) than the Caucasian comparison groups. Regardless of family history of prostate cancer, prostate size, number of positive cores and highest percent positive in any individual core was not significantly different between African American and Caucasians. Pre-operatively, PSA was significantly more elevated in African American with positive family history than in Caucasians (10.1 ng/mL vs. 6.3 ng/mL, p < 0.01). This did not hold true in patients without family history of prostate cancer. For Caucasians and African American men, pre-operative AUA risk group (p < 0.01):
and clinical stage distribution (p < 0.01) significantly differed in patients without family history, however, were similar in patients with positive family history. Post-operative outcomes including positive surgical margins, pathologic staging were not significantly different. The full table of results is as follows:
Dr. Bradshaw concluded his presentation with the following summary points:
- The impact of family history on prostate cancer outcomes is complex, as it likely impacts natural disease course and physician and patient screening decisions
- However, the isolated presence or absence of prostate cancer in the family does not appear to be associated with a difference in outcomes between African American and Caucasian men
Presented By: Aaron Bradshaw, MD, Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC
Co-Authors: Ram Pathak, MD, Adam Cohen, MD, Bridget Krol, BS, Justin Refugia, MD, Parth Thakker, MD, Shuo Liu, MD, Ashok Hemal, MD
Affiliations: Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC
Written By: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 86th Annual Meeting of the Southeastern Section of the American Urological Association, San Juan, PR, Mar 16 – 19, 2022