Case made for reducing the threshold in blacks


African-American (AA) men with nonpalpable prostate cancer have greater cancer volumes and higher prostatectomy Gleason scores than white men with similar PSA levels at the time of biopsy, according to a study.

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“These data support the need for early prostate cancer detection, especially among younger African-American men, and the concept of lowering the serum PSA threshold for biopsy in these patients from 4 ng/mL to 2.5 ng/mL,” researchers wrote in Cancer (2006;107:75-82).


The incidence of prostate cancer is higher in AA men than in white or Hispanic men, and prostate cancer mortality rates are more than twice as high in AA men as in white or Hispanic men. Racial differences in prostate cancer characteristics have been examined in men who underwent radical prostatectomy or received radiation or hormone therapy, but the relationship between race and disease characteristics in men with nonpalpable prostate cancer has not been explored.