African-American men have lower PSA with low-risk prostate cancer

Prostate cancer is the second most common cancer among men in the United States. African-Americans have the highest risk of developing prostate cancer among any other racial group. Prostate cancer in African-American men also tends to be more aggressive.

Key statistics about African-American men and prostate cancer

·         African American men are twice as likely to develop prostate cancer compared with Caucasian men and are nearly 2.4 times as likely to die from the disease.

·         About 19 percent, or nearly one in five, African-American men will be diagnosed with prostate cancer, and five percent of those will die from this disease.

·         Prostate cancer is the fourth most common reason overall for death in African-American men.

·         The risk of an African-American man developing prostate cancer increases significantly if there is a family history of prostate cancer.

·         African-American men with an immediate family member who had prostate cancer have a one in three chance of developing the disease. Their risk increases to 83 percent with two immediate family members having the disease, and then increases to 97 percent if they have three immediate family members who developed prostate cancer.

·         The American Cancer Society recommends that African-American men discuss testing for prostate cancer with their doctor at age 45, or at age 40 if they have close relatives who have had prostate cancer before age 65.

A new study suggests that African-American men may produce less PSA compared to Caucasian men with low-risk prostate cancer. While more research is needed to confirm these findings, it is possible that the confirmed findings could change the way African-American men with prostate cancer are monitored via active surveillance. The study was published in the Journal of Urology.

The study was conducted at the University of Miami Miller School of Medicine by Oleksandr N. Kryvenko, MD and his colleagues. The study involved 66 African-American men and 348 Caucasian men who all had a Gleason Score 3+3. The researchers measured tumor volume in radical prostatectomy specimens and then compared the patients' PSA, PSA density, PSA mass, as well as clinical and pathologic parameters.

The results showed that while the African-American men had heavier prostate glands, they had the same PSA mass as the Caucasian men with the same tumor volumes. In other words, the PSAD was significantly lower in African Americans. They also found that it was the benign prostate tissue that was contributing less PSA rather than the tumor.

According to the researchers, “This finding has practical implications for active surveillance criteria in African-American men. If benign tissue in African-American men produces less PSA, then the PSAD will be lower compared to Caucasians even when cancer volumes are the same between the 2 groups.”