Should the age specific prostate specific antigen cutoff for prostate biopsy be higher for black than for white men older than 50 years?

I. J. Powell, M. Banerjee, M. Novallo, W. Sakr, D. Grignon, D. P. Wood, J. E. Pontes

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Purpose: Investigators who have examined age specific reference ranges recommend a higher prostate specific antigen (PSA) cutoff for biopsy for black than for white men older than 50 years. We controlled for PSA to determine whether age specific reference range cutoffs for diagnosis defined by the Walter Reed Army Medical Center group (Walter Reed group) would improve the disproportionate prostate cancer prognosis between black and white men. Materials and Methods: We studied 651 consecutive patients who underwent radical prostatectomy at Wayne State University between 1991 and 1995 with a mean followup of 34 months (range 1.5 to 75). Log rank tests were used to determine the homogeneity of survival functions between black and white men with similar PSA ranges, and between groups defined by age specific PSA reference ranges for each race. Results: Disease stage and grade were similar or worse in black men for any PSA range, and biochemical disease-free survival was similar or worse within each range. Black men had a higher percentage of high grade prostate cancer than white men 60 to 69 years old who would not have undergone biopsy using the Walter Reed group proposed PSA cutoff. Conclusions: Black men have similar or worse prostate cancer severity and outcome than white men with similar PSA ranges. Using age specific reference ranges for the PSA test defined by the Walter Reed group, black men have worse outcome than white men after radical prostatectomy. Therefore, we recommend that the PSA cutoff for biopsy should not be higher for black men at any age range.

Original languageEnglish (US)
Pages (from-to)146-149
Number of pages4
JournalJournal of Urology
Volume163
Issue number1
DOIs
StatePublished - Jan 2000

Keywords

  • Blacks
  • Prostate-specific antigen
  • Whites

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Should the age specific prostate specific antigen cutoff for prostate biopsy be higher for black than for white men older than 50 years?'. Together they form a unique fingerprint.

Cite this