Risk of Aggressive Prostate Cancer Higher in Blacks, Elderly

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ORLANDO, Fla.—Black men and men aged 75 years and older are at higher risk than other men for having intermediate- or high-risk prostate cancer (PCa), according to study findings presented at the annual Genitourinary Cancers Symposium.

The findings also showed that a substantial number of PSA-detected PCa patients have either intermediate- or high-risk disease at diagnosis.

The retrospective, population-based study, which was led by Hong Zhang, MD, PhD, of the University of Rochester in Rochester, N.Y., included 70,345 men in the U.S. with PSA-detected T1cN0M0 PCa. Of these, 47.6%, 35.9%, and 16.5% had low-, intermediate-, and high-risk disease, respectively.

Men aged 75 and older accounted for 40% of all patients with high-risk disease. Compared with men younger than 50 years, men aged 75 and older had a nearly 4.5-fold and 9.4-fold increased risk of having intermediate- and high-risk disease, respectively. Compared with white men, black men had a 50% and 84% increased likelihood of having intermediate- and high-risk disease.

Study findings will help physicians and certain patients make more informed decisions regarding whether they want to proceed with PSA testing, although more research and longer follow-up is needed to determine the effect of early detection and intervention on outcome in these high-risk patients, said Dr. Zhang, Associate Professor of Radiation Oncology.

Men with low-risk disease had a PSA below 10 ng/mL and a Gleason score of 6 or less; those with intermediate-risk disease had a PSA level between 10 and 20 and/or a Gleason score of 7; and those with high-risk disease had a PSA level of 20 or high and/or a Gleason score of 8 or higher.

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