More Preclinical PCa, Progression Among Black Men

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Also increased risk of progression to metastatic disease compared with the general population.
Also increased risk of progression to metastatic disease compared with the general population.

(HealthDay News) -- Black men appear to have a higher incidence of preclinical prostate cancer and a higher risk of metastatic progression than the general population, which may warrant a change in screening approach, according to a study published online in Cancer.

Alex Tsodikov, PhD, from the University of Michigan in Ann Arbor, and colleagues estimated the natural history of prostate cancer in black men and the general population using 3 independently developed models. The models used an updated reconstruction of prostate-specific antigen screening, based on the National Health Interview Survey (2005) and on prostate cancer incidence data from the Surveillance, Epidemiology, and End Results program (1975 through 2000).

The models projected that between 30% and 43% (range across models) of black men develop preclinical prostate cancer by age 85 years. This is a risk that is (relatively) 28% to 56% higher than among the general population. Among men who had preclinical disease onset, black men had a similar risk of diagnosis (range, 35% to 49%) as the general population (32% to 44%). However, black men have a higher risk of progression to metastatic disease by the time of diagnosis (44% to 75% higher) than the general population.

"The findings suggest screening black men earlier than white men and support further research into the benefit-harm tradeoffs of more aggressive screening policies for black men," conclude the authors.

References

1. Tsodikov A, Gulati R, de Carvalho TM, et al. Is prostate cancer different in black men? Answers from 3 natural history models. Cancer. doi: 10.1002/cncr.30687
2. Wallner LP, Jacobsen SJ. Prostate cancer in black men: Is it time for personalized screening approaches? Cancer. doi: 10.1002/cncr.30685

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