MP77-07 THE PREVALENCE OF PROSTATE BIOPSY GLEASON SCORE ≥ 7(3+4) EXCEEDS 40% IN YOUNG PUERTO RICAN MEN SCREENED FOR PROSTATE CANCER: A CASE FOR EARLY DETECTION BEFORE AGE 55 IN THIS POPULATION

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening VI1 Apr 2015MP77-07 THE PREVALENCE OF PROSTATE BIOPSY GLEASON SCORE ≥ 7(3+4) EXCEEDS 40% IN YOUNG PUERTO RICAN MEN SCREENED FOR PROSTATE CANCER: A CASE FOR EARLY DETECTION BEFORE AGE 55 IN THIS POPULATION Patricia Maymi and Ricardo Sanchez-Ortiz Patricia MaymiPatricia Maymi More articles by this author and Ricardo Sanchez-OrtizRicardo Sanchez-Ortiz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.547AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While in US Census data only 8.0% of Puerto Ricans (PR) self−identified as “black or African American (AA)”, genomic admixture studies show that average West African ancestry gene values in PR range between 17 and 32%. These data, and the known association between aggressive prostate CaP cancer in AA men may help explain the higher observed CaP mortality in PR. Our goal was to evaluate the pathologic features of young PR men diagnosed through PSA screening to ascertain whether this population should be deemed high−risk and screened from age 40. METHODS Our CaP database was queried for men who diagnosed with asymptomatic CaP through PSA screening before age 55. Clinical variables were compared to men age 55 and older. All slides were reviewed by a pathologist trained at an NCCN−designated cancer center. Statistical analysis was performed with SPSS. RESULTS Of 606 patients, 183 men were identified age≤55 years (yrs.) (mean: 49.7 years, range 38 to 54). Mean serum PSA was 5.7 ng/ml, percent clinical stage T1c: 79.7%, and mean prostate size was 42.7 cc. Patients had undergone prostate biopsies with a mean number of 11.7 cores and a mean of 2.97 positive cores (range 1 to 14). On biopsy, 43.1% (79/183) of men had evidence of Gleason score ≥7(3+4). Patients younger than 55 (Y) were more likely to have a first−degree relative with CaP than older men (28% Y vs. 19.4%, p<0.01) but less likely to have smoked (22.8% Y vs. 33.3%, p< 0.02), have diabetes (9.4% Y vs. 19.6%, p <0.01), hypertension (34.8% Y vs. 58.7%, p< 0.01), a higher clinical stage (T1c 79.7% Y vs. 71.2%, p<0.03), or Gleason score ≥7 on biopsy (43.1% Y vs. 56.4%, p<0.02). There were no significant differences between young and older men with regards to serum PSA (5.7 ng/ml Y vs. 6.1 ng/ml), longest tumor length in any core per side (4.3 mm Y vs. 4.5 mm), total sum of tumor length per side (8.9 mm Y vs. 8.5 mm), percent positive cores (26.3% Y vs. 27.1%), or BMI (28.5 Y vs. 28.2). CONCLUSIONS In this series of Puerto Rican men found to have CaP through early detection, patients <55 yrs. exhibited a 43% risk of harboring Gleason score≥7(3+4) on biopsy. Furthermore, despite a lower prevalence of palpable disease than older patients, younger men exhibited no difference with regards to serum PSA, longest tumor length, total tumor sum in millimeters, and percent positive biopsies, traditional surrogates for tumor volume. These data support the concept that, similar to AA patients, discussions regarding early detection in Puerto Rican men should begin at age 40. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e995 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patricia Maymi More articles by this author Ricardo Sanchez-Ortiz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...