Black men are more often diagnosed and die from prostate cancer, but prostate cancer screening recommendations are based primarily on studies of white men. A new study conducted by researchers at Brigham and Women's Hospital and Harvard School of Public Health T. Chan first examines the results exclusively among black men, and considering that predicts whether an optimized strategy for screening to baseline prostate-specific antigen (PSA) level of prostate cancer this population. The study showed that baseline levels of PSA measured in the middle of life, strongly predicted the risk of total and aggressive prostate cancer, black men in the future. The results are published online in European Urology.
"We found that a baseline PSA measured during middle age is strongly predicted subsequent diagnosis of complete and aggressive prostate cancer," - said the lead author, Mark Preston. "Our results suggest that targeted screening based on PSA medium, can identify black men with a high risk of aggressive prostate cancer, while minimizing the screening in low-risk individuals."
"Black men in the United States is 2.5 times more likely to die from prostate cancer than white men, but it is a screening study to date mainly focused on white men" - said co-author Lorelei Mucci. "Thus, the data from our research on critical gaps in understanding the significant racial difference and offer a potential strategy to reduce mortality from prostate cancer in black men."
The research team applied a targeted approach by risk, using data on the men included in the federally funded study of a cohort of southern community (SCCS), a sample of 86 000 men and women from the South-eastern United States, which included more than 22,000 black men . The team conducted a study involving patients with 197 men aged 40 to 64 years, who developed prostate cancer, including 91 cases of aggressive disease.
The team found that 95 percent of and 97 percent of cases of aggressive prostate cancer had baseline PSA level higher than the average for their age group. The greatest risk were men with PSA levels above the 90 th cent.
The authors noted that the increased risk was observed with PSA levels that were higher than average, but still within the "normal" range - and low enough so as not to lead to follow-up in routine clinical practice.
"These findings do not imply that a prostate biopsy or definitive treatment is required immediately to young men with higher levels of PSA, as this can lead to excessive diagnosis, but they are subjected to more intensive screening PSA to provide earlier detection of cancer and to cure it yet possible, "the authors write.