African American men have a higher incidence of preclinical prostate cancer and are more likely to progress to metastatic disease by the time of diagnosis compared with the general population, according to a study published in Cancer.1
It is well-known that prostate cancer incidence and mortality are higher among African American men compared with the general population in the United States, though the reasons for this are unclear. The purpose of this study was to determine the driving mechanism for this higher incidence using modeling techniques.
“If black men have a higher susceptibility to prostate cancer and/or a greater tendency to develop aggressive disease, then it may be of value to consider different screening policies for them,” wrote the authors.
The study used 3 independently developed models to estimate the natural history of prostate cancer among African American men and the general population. The models considered prostate-specific antigen screening patterns and longitudinal claims data to estimate screening intervals.
Prostate cancer data were collected from the National Health Interview Study in 2005 and the Surveillance, Epidemiology, and End Results program between 1975 and 2000.
The models estimated that African American men had a higher risk of developing preclinical prostate cancer by age 85, with an incidence of 30% to 43% compared with 24% to 29% in the general population.
The risk of clinical diagnosis, however, was similar between African Americans (35% to 49%) and other races (32% to 44%).
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African American men also had a 44% to 75% relative higher risk of progressing to metastatic disease than the general population.
According to the authors, the results of this study “support prior suggestions to explore different screening policies among white men and black men.”
- Tsodikov A, Gulati R, de Carvalho TM, et al. Is prostate cancer different in black men? Answers from 3 natural history models. Cancer. 2017 Apr 24. doi: 10.1002/cncr.30687 [Epub ahead of print]