Racial disparities in future development of lethal prostate cancer based on PSA levels in midlife

You have accessJournal of UrologyCME1 Apr 2023MP77-04 RACIAL DISPARITIES IN FUTURE DEVELOPMENT OF LETHAL PROSTATE CANCER BASED ON PSA LEVELS IN MIDLIFE Matthew Davis, Alexander Stephens, Chase Morrison, Sami Majdalany, Rafe Affas, Sohrab Arora, Nicholas Corsi, Ivan Rakic, Akshay Sood, Craig Rogers, and Firas Abdollah Matthew DavisMatthew Davis More articles by this author , Alexander StephensAlexander Stephens More articles by this author , Chase MorrisonChase Morrison More articles by this author , Sami MajdalanySami Majdalany More articles by this author , Rafe AffasRafe Affas More articles by this author , Sohrab AroraSohrab Arora More articles by this author , Nicholas CorsiNicholas Corsi More articles by this author , Ivan RakicIvan Rakic More articles by this author , Akshay SoodAkshay Sood More articles by this author , Craig RogersCraig Rogers More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous literature has examined prostate cancer (PCa) mortality in a Scandinavian population based on midlife PSA results. The aim of our study was to examine racial disparities in PCa mortality based on midlife PSA results in a North American population. METHODS: Our cohort included self-identified White and Black men aged 40-59 years, who received their first PSA through our health system between the years 1995 and 2019. Next, patients were divided into 4 categories based on age as follows: 40 to 44, 45 to 49, 50 to 54, and 55 to 59 years. First PSA testing represented the main predictor of interest, and it was categorized based on median and 90th percentile for each age category. Fine-Gray regression was used to examine the impact of the value of PSA at first testing on the risk of developing lethal PCa (i.e. PCa-specific mortality) by race after accounting for all confounders including Charlson comorbidity index among others. Cancer-specific mortality and overall mortality were obtained by linking our database to the Michigan Vital Records registry. RESULTS: A total of 112,967 men met inclusion criteria, of whom 82,084 (73%) were White and 30,883 (27%) were Black. Median and 90th percentile PSA were 0.7 and 2.0 ng/ml, respectively, in White men compared to 0.7 and 2.1 ng/ml, respectively, in Black men. For White men aged 40 to 44, 45 to 49, 50 to 54, and 55 to 59 years, median PSA was respectively 0.6, 0.7, 0.7, and 0.9 ng/ml compared to 0.6, 0.7, 0.8, and 0.9 ng/ml in Black men. The 90th percentile PSA in White men was respectively 1.3, 1.6, 2.0, and 2.8 ng/ml compared to 1.4, 1.8, 2.4, and 3.8 ng/ml in Black men. For the same age categories, the estimated rate of lethal PCa at 20 years was significantly higher in Black men when using the 90th percentile PSA cutoff (see Table 1). Median (IQR) follow-up was 6.7 (2.9 - 14.4) years for White men and 9.9 (4.4 - 16.4) years for Black men. On multivariable analysis, these findings were confirmed. CONCLUSIONS: Our findings suggest that Black men are significantly more likely to develop lethal PCa based on previously published midlife first-time PSA cutoffs. This information suggests that a lower midlife PSA cutoff could be considered amongst Black men. To the best of our knowledge, our report is the first to examine the racial disparities in lethal PCa based on first-time PSA results in a diverse North American cohort. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1102 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Davis More articles by this author Alexander Stephens More articles by this author Chase Morrison More articles by this author Sami Majdalany More articles by this author Rafe Affas More articles by this author Sohrab Arora More articles by this author Nicholas Corsi More articles by this author Ivan Rakic More articles by this author Akshay Sood More articles by this author Craig Rogers More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...