MP40-02 BASELINE PSA LEVELS IN MIDLIFE & FUTURE DEVELOPMENT OF LETHAL PROSTATE CANCER: A DIVERSE NORTH AMERICAN COHORT ANALYSIS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP40-02 BASELINE PSA LEVELS IN MIDLIFE & FUTURE DEVELOPMENT OF LETHAL PROSTATE CANCER: A DIVERSE NORTH AMERICAN COHORT ANALYSIS Matthew Davis, Alexander Stephens, Chase Morrison, Sami Majdalany, Rafe Affas, Sohrab Arora, Nicholas Corsi, Ivan Rakic, Akshay Sood, Craig Rogers, and Firas Abdollah Matthew DavisMatthew Davis More articles by this author , Alexander StephensAlexander Stephens More articles by this author , Chase MorrisonChase Morrison More articles by this author , Sami MajdalanySami Majdalany More articles by this author , Rafe AffasRafe Affas More articles by this author , Sohrab AroraSohrab Arora More articles by this author , Nicholas CorsiNicholas Corsi More articles by this author , Ivan RakicIvan Rakic More articles by this author , Akshay SoodAkshay Sood More articles by this author , Craig RogersCraig Rogers More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003278.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of our study was to examine prostate cancer (PCa) mortality based on midlife prostate-specific antigen (PSA) results in a racially diverse North American population. METHODS: Our cohort included all men aged 40-59 years, who received their first PSA through our health system between the years 1995 and 2019. Next, patients were divided into 4 categories based on age as follows: 40 to 44, 45 to 49, 50 to 54, and 55 to 59 years. First PSA testing represented the main predictor of interest, and it was categorized based on median and 90th percentile for each age category. Fine-Gray regression was used to examine the impact of the value of PSA at first testing on the risk of developing lethal PCa (i.e. prostate cancer-specific mortality) after accounting for all confounders including race and comorbidity among others. Cancer-specific mortality and overall mortality were obtained by linking our database to the Michigan Vital Records registry. RESULTS: A total of 129,067 men met inclusion criteria during the study period, of which 82,084 (64%) were White, 30,883 (24%) were Black, and 16,100 (12%) were other race. Median and 90th percentile PSA were 0.7 and 2.0 ng/ml, respectively. For men aged 40 to 44, 45 to 49, 50 to 54, and 55 to 59 years, median PSA was respectively 0.6, 0.7, 0.7, and 0.9 ng/ml, and the 90th percentile PSA was respectively 1.4, 1.6, 2.1, and 3.0 ng/ml. For the same age categories, the estimated rate (95% CI) of lethal PCa at 20 years was 0.023% (0.003-0.130%), 0.14% (0.071-0.25%), 0.33% (0.19-0.54%), 0.51% (0.34-0.75%) in men with PSA < median, and 0.79% (0.22-2.2%), 0.16% (1.04-2.45%), 2.5% (1.80-3.35%), 5.4% (4.28-6.76%) in men with PSA ≥90th percentile. Median (IQR) follow-up was 7.8 (3.2-15.0) years. On multivariable analysis, men with a PSA≥90th percentile had a 11.57 HR (95% CI: 8.71-15.35) times higher risk of developing lethal PCa, when compared to those with PSA<median at first testing. This HR (95% CI) was 11.03 (2.01-60.57), 13.96 (6.93-28.13), 13.01 (7.62-22.23), and 10.47 (7.09-15.47) for men aged 40 to 44, 45 to 49, 50 to 54, and 55 to 59 years, respectively. CONCLUSIONS: Our findings suggest that midlife first-time PSA is an important predictor of the subsequent risk of developing lethal PCa. This information can be used to develop a PSA screening program, which is tailored to the patient’s specific risk. To the best of our knowledge, our report is the first to examine the role of first-time PSA in a diverse North American cohort. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e545 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Davis More articles by this author Alexander Stephens More articles by this author Chase Morrison More articles by this author Sami Majdalany More articles by this author Rafe Affas More articles by this author Sohrab Arora More articles by this author Nicholas Corsi More articles by this author Ivan Rakic More articles by this author Akshay Sood More articles by this author Craig Rogers More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...