1201 EARLIER AGE FOR PROSTATE CANCER SCREENING OF AFRICAN AMERICAN MEN IS NEEDED TO ELIMINATE RACIAL MORTALITY DISPARITY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening1 Apr 20111201 EARLIER AGE FOR PROSTATE CANCER SCREENING OF AFRICAN AMERICAN MEN IS NEEDED TO ELIMINATE RACIAL MORTALITY DISPARITY Isaac Powell, Fawn Vigneau, Julie Ruterbusch, Lance Heilbrun, and Cathryn Bock Isaac PowellIsaac Powell Detroit, MI More articles by this author , Fawn VigneauFawn Vigneau Detroit, MI More articles by this author , Julie RuterbuschJulie Ruterbusch Detroit, MI More articles by this author , Lance HeilbrunLance Heilbrun Detroit, MI More articles by this author , and Cathryn BockCathryn Bock Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.836AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The prostate cancer (PCa) mortality rate is more than twice as high among African American men (AAM) compared to European American men (EAM) and is unchanged from 1995 to 2007. The Behavioral Risk Factor Surveillance Study (BRFSS) from CDC reports similar PSA testing among AAM and EAM age 50 and above, and from 2000 to 2006 81% and 88% of AAM and EAM, respectively, have insurance. Thus access to care appears to have had minimal effect on the significant mortality disparity. Since metastatic PCa most likely contributes to PCa specific mortality, we examined metastatic PCa incidence and survival. METHODS We used SEER data to select primary distant stage prostate cancers diagnosed 1995–2002 (survival follow-up through December 31, 2007), to calculate age-adjusted 5-year relative survival rates by year of diagnosis and race. We then calculated age-specific incidence rates of distant prostate cancer in AAM and EAM for ages 40–79. Rate ratios were calculated comparing AAM to EAM within each age stratum. RESULTS The final dataset for the survival analysis included N=2,133 black (African-American) and N=8,961 white (European-American) cases. 95% confidence intervals indicated no statistical difference in survival rates between AAM and EAM by year of diagnosis of distant stage prostate cancer for this time period. (Graph 1). The incidence analysis included N=2,134 AAM and N=7,919 EAM cases. In each age group, AAM with distant disease had significantly higher incidence than EAM. (Table 1). CONCLUSIONS The recent Swedish PCa screening study has reported a 44% decrease in mortality among men screened for PCa. We report similar survival among AAM and EAM diagnosed with metastatic PCa but yet a 3-fold disproportionate incidence of metastatic disease in AAM compared to EAM for ages 40 to 59 and above. We recently reported that PCa grows faster among AAM compared to EAM because of biological/genetic factors. We hypothesize that if the cancer is diagnosed early enough these factors may not be contributory. Therefore we conclude that earlier age for more robust screening among AAM is necessary to significantly reduce or eliminate racial PCa mortality disparity. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e482 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Isaac Powell Detroit, MI More articles by this author Fawn Vigneau Detroit, MI More articles by this author Julie Ruterbusch Detroit, MI More articles by this author Lance Heilbrun Detroit, MI More articles by this author Cathryn Bock Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...