Race does not influence the risk for prostate cancer upgrading while on active surveillance (AS), according to a poster presentation at the American Urological Association’s 2022 annual meeting in New Orleans, Louisiana..
Using the equal-access Southeast Louisiana Veterans Health Care System database, investigators identified 154 Black and 74 White men undergoing prostate cancer AS. At diagnosis, there were no significant differences in age, family history of prostate cancer, smoking status, PSA, PSA density, prostate volume, or number of positive biopsy cores.
In multivariate analysis, race did not significantly predict the risk for upgrading to Gleason 2 or higher disease, Joshua Pincus, MD, a medical student at Tulane University School of Medicine in New Orleans, Louisiana, reported. Only the number of cores positive for cancer significantly predicted a 32% increased risk for upgrading. Other factors such as age, body mass index, PSA, PSA density, and family history of prostate cancer did not appear predictive.
On Kaplan-Meier analysis, the probability of upgrading-free survival was 71% for Black and 72% for White patients at 2.5 years and 48% vs 58%, respectively, at 5 years, differences that were not significant.. At the study’s end, 47% of patients remained on AS or without local curative therapy.
“AS is a safe treatment option for low and very-low risk prostate cancer, regardless of race,” Pincus concluded in a study abstract.
Pincus J, Greenberg JW, Koller C, Silberstein J, Krane S. A 5-year prospective study of African American men on prostate cancer active surveillance: Does race predict upgrading? Presented at: AUA 2022; May 13-16, 2022, New Orleans, Louisiana. Abstract MP43-15.