The Impact of Race on Oncological Outcomes in Patients with an Initial Negative Prostate Biopsy: Results from a Contemporary North America Cohort

Document Type

Conference Proceeding

Publication Date

5-1-2026

Publication Title

Eur Urol

Keywords

adult, aged, cancer mortality, Caucasian, cohort analysis, conference abstract, controlled study, diagnosis, drug therapy, follow up, human, major clinical study, male, North America, prognosis, prostate biopsy, prostate cancer, race, racial disparity, retrospective study, socioeconomics

Abstract

Introduction & Objectives: Although previous studies demonstrated favorable long-term oncological outcomes in men who had an initial negative prostate biopsy, exhaustive evidence about the impact of racial disparities in this setting is still lacking. We assessed the relationship between race and long-term oncological risk among men with an initial negative prostate biopsy using a contemporary North-American cohort. Materials & Methods: We included all the Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) men who had a negative prostate biopsy at a tertiary center between 1995-2023. An Area Deprivation Index (ADI) score was assigned to each patient based on their residential census-block group. The higher the ADI, the more the area has a socio-economic disadvantage. Competing-risk methods were used to estimate the cumulative incidence of clinically significant PCa diagnosis, receipt of active treatment and Prostate Cancer Specific Mortality (PCSM), after stratification according to self-reported race. Competing-risk Fine-Grey regression models were used to test the impact of self-reported race on the aforementioned outcomes. Results: Of 17446 men included, 5729 (30.3%) were NHB. NHB patients were more likely to have higher ADI percentile (78 vs 53), CCI≥2 (13.9% vs 10.6%), and more frequently received a second biopsy over the analysed timeframe (36.1% vs 30.6%), compared to their NHW counterparts (all p<0.0001). Within a median follow-up time (IQR) of 7.8 years (2.8-13.5), the 15-years estimated rates of clinically significant PCa diagnosis, receipt of active treatment and PCSM were 10.7%vs6.4%, 10.4%vs6.4% and 2.4%vs1.3%, for NHB versus NHW patients, respectively (all p<0.0001). At multivariable regression analysis, after adjusting for socioeconomic disadvantage (ADI), NHB men had significantly higher hazard of clinically significant PCa diagnosis (HR:1.91, p<0.001), active treatment for PCa (HR:1.84, p<0.001) and PCSM (HR:1.89, p<0.001). Conclusions: Our findings demonstrated that NHB men, even after an initial negative prostate biopsy, face a higher risk of subsequent clinically significant PCa, active treatment and PCSM compared to NHW men. These findings underscore the multifaceted impact of racial and socioeconomic factors on PCa management and prognosis, emphasizing their significant role in shaping oncological outcomes.(Table Presented)

Volume

89

Issue

5s

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