Active Surveillance for African-American Men with Prostate Cancer
Abstract
Active surveillance (AS) is an appropriate method to avoid overtreatment for many men with early prostate cancer (PC). However, whether African-American (AA) men can safely undergo AS is controversial due to the higher risk of death from PC and the lack of data on AS in this population. We identified 5,774 men (1,456 AA, 4,318 non-Hispanic White (NHW)) that were initially managed with AS. Progression to definitive treatment was more common in AA men than NHW men (10-year cumulative incidence: 60.7 percent AA vs. 49.1 percent NHW, subdistribution hazard ratio (SHR) 1.18, p< 0.01). Of those who proceeded to treatment, progression to Gleason Score 7 or higher was the most common reason (52.3 percent AA vs 43.1 percent, p < 0.01). There were no significant differences in the cumulative incidence of metastases (10-year cumulative incidence: 1.96 percent AA vs. 2.80 percent NHW, SHR: 0.92, p=0.81), death from prostate cancer, (10-yearcumulative incidence: 1.00 percent AA vs. 0.86 percent NHW, SHR: 1.16, p=0.69), or all-cause mortality (10-year cumulative incidence: 15.9 percent AA vs. 17.4 percent NHW, SHR: 0.91, p=0.14). Although progression to definitive treatment was higher, we found no evidence that metastasis or death from prostate cancer was more common in AA men.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 2020
- Accession Number
- AD1134743
Entities
People
- Brent S Rose
Organizations
- University of California