Prostate cancers in black men could be missed through active surveillance

Prostate cancers in black men could be missed as a result of active surveillance, a new study has found.

The research from Johns Hopkins found that African-Americans diagnosed with low-risk prostate cancers are more likely than white men to have an aggressive disease that is unrecognised with existing diagnostic approaches.

A report of the study has been posted online in the Journal of Clinical Oncology, where it has been described as the biggest assessment of race-based health disparities in men diagnosed with a slow-growing, non-aggressive form of prostate cancer.

The findings highlighted that preoperative characteristics were similar for very-low-risk whites and blacks, but black men had worse Charlson comorbidity index scores, which assesses life expectancy.

A detailed analysis also showed that black men had a lower rate of organ-confined cancers at 87.9 per cent and a significantly higher hazard of prostate-specific antigen (PSA)-defined biochemical recurrence (BCR) of prostate cancer.

Urologist Edward M. Schaeffer, a co-author of the study, said: “This is critical information because if African-American men do have more aggressive cancers, as statistics would suggest, then simply monitoring even small cancers that are very low risk would not be a good idea because aggressive cancers are less likely to be cured.

“We think we are following a small, non-aggressive cancer, but in reality, this study highlights that in black men, these tumors are sometimes more aggressive than previously thought.”

He went on to say that alternate race-specific surveillance entry criteria should be developed and utilised for African-American men to guarantee oncologic parity with their white counterparts.

New strategies are also being developed to accurately risk-classify African-Americans with newly diagnosed prostate cancer, which should improve chances of survival.

However, Mr Schaeffer admitted that the figures are restricted because they are from a retrospective analysis of the experiences of a single academic medical centre.

Posted by Fiona Griffiths