You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History III1 Apr 2017PD47-06 LOWER RISK OF PROSTATE CANCER IN ASIAN MEN: FROM LESS SCREENING OR TRUE RACIAL DIFFERENCES? Tom Feng, Alexis Freedland, Lauren Howard, Adriana Vidal, Daniel Moreira, Ramiro Castro-Santamaria, Gerald Andriole, and Stephen Freeland Tom FengTom Feng More articles by this author , Alexis FreedlandAlexis Freedland More articles by this author , Lauren HowardLauren Howard More articles by this author , Adriana VidalAdriana Vidal More articles by this author , Daniel MoreiraDaniel Moreira More articles by this author , Ramiro Castro-SantamariaRamiro Castro-Santamaria More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , and Stephen FreelandStephen Freeland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2366AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Global prostate cancer incidence rates are lower in Asian men than white men. To what degree this relates to less aggressive screening in Asian men or inherent differences by race remains to be determined. Our aim was to determine whether Asian race was associated with lower prostate cancer diagnosis in a study of all men who received prostate-specific antigen (PSA) screening and systematic prostate biopsies independent of PSA levels. METHODS REDUCE was a 4-year, multicenter, randomized, double-blind, placebo-controlled study that followed biopsy-negative men with protocol-dictated PSA-independent biopsies at 2- and 4-years. Eligible men were aged 50-75 years, had serum PSA between 2.5-10 ng/mL, and a prior negative prostate biopsy. We tested the association between race and receipt of prostate biopsy as well as race and prostate cancer diagnosis using multivariable logistic regression. RESULTS Of 8,122 men in REDUCE, 7,296 were of white or Asian race and had complete data for analysis. Asian men had lower BMI (24.8 vs 26.9, p<0.001) and smaller prostate volumes (34.2 vs 43.4 cc, p<0.001) but were similar in baseline age, PSA, family history of prostate cancer, and digital rectal exam findings compared to white men. There was no difference in rate of receiving a prostate biopsy between Asian and white men (p=0.634). After adjusting for various clinical and demographic characteristics, Asian men were less likely to be diagnosed with cancer during the 4-year study compared to white men (OR 0.56, p=0.011). When testing for differences in cancer grade, Asian race was significantly associated with decreased risk of low-grade cancer compared to white race (OR 0.43, p=0.016). This risk reduction was also observed for high-grade cancer (OR 0.63, p=0.290) though the association was not statistically significant. CONCLUSIONS Among men with a negative pre-study biopsy who all underwent biopsies largely independent of PSA, Asian race was associated with reduced risk of prostate cancer diagnosis. These data suggest less screening among Asian men globally cannot completely explain the lower risk of prostate cancer among Asian men. Further studies are needed to explore the inherent differences attributed by race in prostate cancer diagnosis. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e898 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Tom Feng More articles by this author Alexis Freedland More articles by this author Lauren Howard More articles by this author Adriana Vidal More articles by this author Daniel Moreira More articles by this author Ramiro Castro-Santamaria More articles by this author Gerald Andriole More articles by this author Stephen Freeland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...