A Retrospective Study on Pathologic Features and Racial Disparities in Prostate Cancer.
Steven A Bigler, Xinchun Zhou. University of Mississippi Medical Center, Jackson
Background: Race along with age and family history are the established risk factors for prostate cancer. African Americans (AA) have higher incidence and mortality rates than Caucasians (Cau) from prostatic adenocarcinoma. However, racial disparities are still controversial in many clinical and pathologic features of prostate cancer. Imbalanced racial proportion of studied subjects and degree in mixture of ethnic origins are two factors which could contribute to differences among studies. Our patient population is approximately an equal proportion of AA and Cau with few other ethnic groups represented.
Design: Pathology reports and clinical information from 3,315 prostatic surgical specimens were reviewed. Racial disparities were analyzed between AA and Cau for clinical and pathological features at the time of first biopsy, time of diagnosis of prostate cancer and time of radical prostatectomy.
Results: At the time of the first biopsy, AA had significantly higher detection rate of prostate cancer (50.3% vs. 38.3%, p<0.0001), higher serum level of PSA (11.6 vs. 7 ng/ml, p<0.0001) and higher Gleason scores (6.9 vs. 6.3, p<0.0001) as compared to Cau at a significant younger age (63.2 vs. 64.7 years old, p=0.027). The disparities of these features remained similar at the time of diagnosis of prostate cancer between the two races. At the time of prostatectomy, AA, as compared to Cau had higher positive surgical margin (33.5% vs. 19.7%, p=0.0005), larger tumor size (8 vs. 3.4 ml, p=0.002) and more bilaterally distributed prostate cancer (61.5% vs. 35.4%, p<0.0001) at a significantly younger age (58.7 vs. 61.5 years old, p=0.0005). AA also had higher detection rate of prostate cancer by repeat sampling with a shorter time interval to diagnosis of prostate cancer from previous biopsies with diagnoses of PIN or ASAP. In addition, prostate cancer precursors was significantly left-sided predominance (62% at left, 38% at right, p=0.00543); this tendency remained for prostate cancer with lower grade (Gleason score 2-3).
Conclusions: This retrospective study conducted in a conservative area with a balanced distribution of AA and Cau populations demonstrated racial disparities in detection rate of prostate cancer, serum PSA level, tumor grade, positive surgical margins, tumor volume, and percentage of bilateralism. The study also demonstrated a left-sided predominance of prostate cancer precursors and prostate cancer with lower grade.
Category: Genitourinary (including renal tumors)
Monday, February 28, 2011 1:00 PM
Poster Session II # 133, Monday Afternoon