MP60-16 THE RELATIONSHIP OF BASELINE PROSTATE SPECIFIC ANTIGEN LEVELS AND RISK OF FUTURE PROSTATE BIOPSY POSITIVE FOR ADENOCARCINOMA AND ITS VARIANCE BY RACE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening II1 Apr 2015MP60-16 THE RELATIONSHIP OF BASELINE PROSTATE SPECIFIC ANTIGEN LEVELS AND RISK OF FUTURE PROSTATE BIOPSY POSITIVE FOR ADENOCARCINOMA AND ITS VARIANCE BY RACE Daniel Verges, M.D. William Andrew Sterling, William Atallah, M.D. Jeremy Weedon, andPhD. Nicholas KaranikolasM.D. Daniel VergesDaniel Verges More articles by this author , William Andrew SterlingWilliam Andrew Sterling More articles by this author , William AtallahWilliam Atallah More articles by this author , Jeremy WeedonJeremy Weedon More articles by this author , and Nicholas KaranikolasNicholas Karanikolas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2218AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In the Malmo Preventative Medicine Study Lilja et al. found that median PSA levels were noticeably lower in men who did not get cancer relative to those who did get cancer. Critics of the Malmo study cite limitations of generalizability of findings due to ethnic homogeneity. As such we sought to investigate the relationship between PSA and risk of future prostate cancer diagnosis in a black majority-minority cohort. METHODS We hypothesized that lower baseline PSA is protective regarding risk of future prostate cancer (CaP) and that black men would have higher baseline PSA compared to white men. We performed retrospective analysis of our prostate biopsy database of 994 men referred to Urology and biopsied between 2007-2014. Logistic regression was used to predict positive biopsy result from log-transformed baseline PSA, race, +/-prostatitis, family history of CaP, age at biopsy and histology, and PSA change from baseline to time of biopsy. The Hosmer-Lemeshow method was used to test fit of data to model. RESULTS In our cohort 50.2% of men identified as black. There were 523 positive biopsies. Controlling for covariates, whites were significantly less likely to have a positive biopsy (+Bx) than either blacks (black v white OR=89, 95% CI [22,364]) or others (other v white OR=25, 95% CI [5.7,110). There was no statistically significant interaction between baseline PSA & race (p=0.466). Baseline PSA was not a statistically significant independent predictor of Bx result (p=0.101). There was however a statistically significant interaction between PSA change score & race (p=0.031). OR for a 1-unit increase in PSA change score among whites was 1.20 (95% CI [1.07, 1.34]); the corresponding OR among blacks was 1.06 (95% CI [1.02, 1.10]); and among others was 1.03 (95% CI [0.99, 1.07]). CONCLUSIONS In our majority-minority population, baseline PSA values were not statistically significantly associated with risk of future +Bx. Change in PSA score from baseline to time of biopsy had very modest additional predictive utility among whites; less so among blacks. Thus our null hypothesis that a lower 1st PSA value at referral to Urology predicts a lower chance of being diagnosed with prostate cancer was not supported. This finding conflicts with the Malmo data. However, our data do support the higher risk of prostate biopsy positive for malignancy in black men with elevated PSA relative to white men with elevated PSA. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e744-e745 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Verges More articles by this author William Andrew Sterling More articles by this author William Atallah More articles by this author Jeremy Weedon More articles by this author Nicholas Karanikolas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...