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J Natl Med Assoc. 2006 Apr;98(4):515-9.

Prostate cancer screening and detection in inner-city and underserved men.

Author information

1
Division of Urology, University of Florida, Jacksonville 32209, USA.

Abstract

CONTEXT:

In the era of serum prostate-specific antigen (PSA) screening, the incidence of prostate cancer has increased dramatically. Simultaneously however, stage migration has occurred, and treatment outcomes have improved. Inner-city men have lower screening rates and, thus, may be diagnosed with more advanced disease that it less likely to be successfully treated.

OBJECTIVE:

To assess the detection rate of prostate cancer and tumor stage at presentation in inner-city men.

DESIGN, SETTING, AND PATIENTS:

A retrospective cohort of 368 men underwent transrectal ultrasound needle-guided biopsy at an inner-city hospital from January 2003 to May 2005. Clinical and pathologic data were collected and analyzed.

MAIN OUTCOME MEASURES:

Clinic and hospital records were reviewed for several key outcomes, including prostate cancer incidence, tumor stage and tumor grade.

RESULTS:

The median age of the cohort was 67 +/- 9.1 years (range, 23-93 years). Prostate cancer was diagnosed in 44% of subjects (161/368). The median PSA level at the time of diagnosis was significantly higher in African-American men than in Caucasian men (9.82 vs. 5.97 ng/mL, P=0.008). Abnormally high serum PSA levels (>20 ng/mL) were present in disproportionately more African-American men than Caucasian men with prostate cancer (32.9% vs. 19.7% P=0.011). African-American men in this inner-city cohort also had a higher incidence of advanced disease or distant metastasis (T3/T4, N1, or M1) than did Caucasians (16.1% vs. 3.8%; P=0.045).

CONCLUSIONS:

Compared with inner-city Caucasian men, disproportionately more inner-city, African-American men present with advanced prostate cancer. This observation warrants prostate cancer education and consideration of early detection programs in underserved inner-city communities.

PMID:
16623063
PMCID:
PMC2569232
[Indexed for MEDLINE]
Free PMC Article
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