Introduction: There is continuing controversy about prostate cancer (PCa) testing and the recent AUA guidelines.
We hypothesize that the reduction and elimination of racial survival disparity among AAM (high risk group)compared to EAM (intermediate risk group) during the PSA testing era compared to the pre-PSA era strongly supports the use of PSA testing in AAM.
Method: We used Surveillance, Epidemiology and End Results (SEER) data to investigate relative survival disparities between AAM and EAM. To evaluate pre-PSA testing era, we selected malignant first primary prostate cancer in AAM and EAM males, all stages, diagnosed 1973-1994. To evaluate relative survival disparities in the current PSA testing era, we selected malignant first primary local, regional and distant stage prostate cancers diagnosed 1998-2005 to calculate five-year relative survival rates.
Results: Age-adjusted five-year relative survival of prostate cancer diagnosed 1973-1994 in the national SEER data revealed significantly shorter survival for AAM compared to EAM (p < 0.0001). The SEER-based survival analysis from 1995 to 2005 indicated no statistical difference in relative survival rates between AAM and EAM by year of diagnosis of local, regional or distant stage PCa.
Conclusion: We conclude that the elimination of PCa racial disparity of local, regional and metastatic PCa relative survival in the current PSA testing era compared to pre-PSA era as an endpoint to test PSA efficacy as a marker for PCa diagnosis is evidence for aggressive testing of AAM. Impact: Evidence for screening African American men.
Written by:
Powell IJ, Vigneau FD, Bock C, Ruterbusch J, Heilbrun LK. Are you the author?
Urology, Wayne State University/Karmanos Cancer Inst., 4201 St Antoine UHC 7C, Detroit, MI.
Reference: Cancer Epidemiol Biomarkers Prev. 2014 May 6. Epub ahead of print.
doi: 10.1158/1055-9965.EPI-13-1328
PubMed Abstract
PMID: 24802741
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