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). However, 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-year cumulative 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). We found that PSA velocity was strong predictor of progression to Gleason Grade Group 2 and 3. Furthermore, AA men were likely to experience progression at lower PSA velocities. These results show that surveillance can be a successful way to manage low-risk PC in AA men and to identify the safest way to follow AA men on surveillance.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 2021
- Accession Number
- AD1153318
Entities
People
- Brent S Rose
Organizations
- University of California, San Diego