Differential impact of prostate-specific antigen screening pattern on prostate cancermortality among non-Hispanic black and non-Hispanic white men: A large, urban health system cohort analysis
Recommended Citation
Cirulli GO, Davis M, Finati M, Chiarelli G, Stephens A, Corsi N, Williams E, Affas RS, Arora S, Sood A, Lughezzani G, Buffi NM, Carrieri G, Salonia A, Briganti A, Montorsi F, Rogers CG, Abdollah F. Differential impact of prostate-specific antigen screening pattern on prostate cancermortality among non-Hispanic black and non-Hispanic white men: A large, urban health system cohort analysis. Eur Urol 2024; 85:S404-S405.
Document Type
Conference Proceeding
Publication Date
3-1-2024
Publication Title
Eur Urol
Keywords
prostate specific antigen, adult, aged, cancer mortality, Caucasian, cohort analysis, conference abstract, diagnosis, follow up, Hispanic, human, major clinical study, male, middle aged, prostate cancer, retrospective study, urban health
Abstract
Introduction & Objectives: Randomized studies assessing the effect of prostate-specific antigen (PSA) screening on mortality in Non- Hispanic Black men (NHB) are lacking. The aim of our study was to assess the association between PSA screening and survival among NHB men in comparison to Non-Hispanic White (NHW) men in a racially diverse real-world North American population. Materials & Methods: The study cohort included 6,378 men who self-identified as NHB or NHW and were diagnosed with prostate cancer (PCa). They received PSA screening and subsequent PCa treatment and follow-up at our institution between the years 2000 and 2019. Patients were sorted based on PSA testing intensity for the 5 years prior to diagnosis, as follows: never, some (<1 test/year), and annual testing (1 test/year). The primary outcome was risk of prostate cancer-specific mortality (PCSM) among NHB and NHW. Competing-risk cumulative incidence curves estimated PCSM rates. Fine-Gray regression analyses examined the impact of PSA testing on PCSM. Results: Median (IQR) age and PSA at diagnosis were 67 (60 - 73) years and 5.8 (4.4 - 9.6) ng/ml, respectively and 2,929 (45.9%) men were NHB. Annual PSA testing was more frequent in NHW (5.2%) than in NHB (3.2%) men (p<0.001). On cumulative incidence analysis, in the never, some, and annual PSA testing groups, the 10-year PCSM was respectively 12.3%, 5.8%, and 4.6% in NHW and 18.5%, 7.0%, 1.2% in NHB patients (both p<0.001). On multivariable analysis, a more intensive PSA testing strategy was associated with more favorable PCSM rates for NHB (HR: 0.38; 95% CI 0.22-0.64; p < 0.001) as well as NHW men (HR: 0.56; 95% CI 0.34-0.93; p=0.025). Conclusions: In this retrospective cohort study, annual PSA testing was associated with a reduced risk of PCSM in both NHB and NHW men who were diagnosed with PCa. NHB men seemed to benefit from frequent PSA testing compared to their NHW counterparts. [Figure presented]
Volume
85
First Page
S404
Last Page
S405
