Mp19-02 Midlife Baseline Psa as a Predictor of Lethal Prostate Cancer: Racial Differences Between Black and White Men

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP19)1 May 2024MP19-02 MIDLIFE BASELINE PSA AS A PREDICTOR OF LETHAL PROSTATE CANCER: RACIAL DIFFERENCES BETWEEN BLACK AND WHITE MEN Giuseppe Chiarelli, Davis Matthew, Alex Stephens, Marco Finati, Giuseppe O. Cirulli, Chase Morrison, Shane Tinsley, Akshay Sood, Giuseppe Carrieri, Alberto Briganti, Francesco Montorsi, Giovanni Lughezzani, Nicolò Buffi, Craig Rogers, and Firas Abdollah Giuseppe ChiarelliGiuseppe Chiarelli , Davis MatthewDavis Matthew , Alex StephensAlex Stephens , Marco FinatiMarco Finati , Giuseppe O. CirulliGiuseppe O. Cirulli , Chase MorrisonChase Morrison , Shane TinsleyShane Tinsley , Akshay SoodAkshay Sood , Giuseppe CarrieriGiuseppe Carrieri , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , Giovanni LughezzaniGiovanni Lughezzani , Nicolò BuffiNicolò Buffi , Craig RogersCraig Rogers , and Firas AbdollahFiras Abdollah View All Author Informationhttps://doi.org/10.1097/01.JU.0001008716.22569.77.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Most previous reports have examined prostate cancer (PCa) mortality in homogenous populations based on midlife baseline PSA (MB PSA), defined as the first PSA test performed between 40 and 59 years old. Our study aims to investigate racial disparities in the predictive value of MB PSA for lethal PCa, defined as death from PCa or the development of metastatic disease either at diagnosis or during follow-up, in a diverse, contemporary, North American population. METHODS: Our cohort included White and Black men aged 40-59 years, who underwent MB PSA through our health system between 1995 and 2019. Patients were divided into 4 categories based on age: 40 to 44, 45 to 49, 50 to 54, and 55 to 59 years. MB PSA testing during the study period represented the main predictor of interest, and it was categorized based on PSA above/below the median in the entire cohort and for each age group. Multivariable Fine-Gray regression (MVA) was used to examine the impact of the MB PSA in predicting lethal PCa by race, after accounting for all confounders including the Charlson comorbidity index among others. RESULTS: A total of 112,967 men met the inclusion criteria, of whom 82,084 (73%) were White and 30,883 (27%) were Black. White patients had their first PSA most frequently in the 50–54 age group (33.9%) while Black patients at 40-44 (27.6%). The rate of PCa diagnosis was 7.0% in Black patients vs. 3.9% in White patients, and lethal PCa was 1.2% vs 0.6%, respectively (both pmedian aged 40-44, 45-49, 50-54, and 55-59 was respectively 2.98 (1.59-5.57), 3.01 (1.89-4.81), 5.10 (3.38-7.70) and 3.38 (2.32-4.92). While the HR of lethal PCa for Black men with PSA>median aged 40-44, 45-49, 50-54 and 55-59 was respectively 5.50 (2.94-10.27), 4.19 (2.59-6.78), 9.79 (6.37-15.04) and 7.53 (5.03-11.26) (all p<0.001). CONCLUSIONS: Our findings indicate that for the same MB PSA and within the same age category, Black men have almost double the risk of developing lethal PCa than White men. This implies that separate and different cut-offs should be created for MB PSA, if this is to be used to guide PSA screening in clinical practice. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e310 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Giuseppe Chiarelli More articles by this author Davis Matthew More articles by this author Alex Stephens More articles by this author Marco Finati More articles by this author Giuseppe O. Cirulli More articles by this author Chase Morrison More articles by this author Shane Tinsley More articles by this author Akshay Sood More articles by this author Giuseppe Carrieri More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Giovanni Lughezzani More articles by this author Nicolò Buffi More articles by this author Craig Rogers More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...