African-American men with family histories of prostate cancer could benefit from a baseline prostate-specific antigen (PSA) reading to determine their probability of developing the disease. Researchers from Northwestern University in Chicago say this new perspective on testing could lead to highly individualized screening protocols based on a man’s baseline level and how it relates to established age-specific medians.
According to new data presented recently during the Annual Scientific Meeting of the American Urological Association (AUA) in Orlando, African-American men with known prostate cancer risk factors with baseline levels higher than the age-specific median are more likely to develop the disease in their lifetimes than the general population. However, African-American men with a family history were unlikely to develop prostate cancer if their baseline PSA level was below the age-specific median.
The effect of the baseline PSA level on future prostate cancer risk was so robust that the correlation held true even for men with other significant risk factors.
Using a study cohort drawn from a longitudinal screening study enrolling more than 26,000 volunteers between 1991 and 2001, researchers analyzed a group of 329 African-American men with a family history of prostate cancer. The volunteers were divided into three groups by ages: 40s, 50s and 60+ with a mean follow-up time of 19.5, 71 and 81 months, respectively. None of the men in their 40s or 50s with both risk factors and a baseline PSA below the median were diagnosed with prostate cancer.
Eight percent of men in their 40s with both risk factors and a PSA above the median were diagnosed, as were 16 percent of men in their 50s. Twice as many men in their 60s with both risk factors and a baseline PSA above the median were diagnosed with prostate cancer.
- Mondo DM, Roehl KA, Loeb S, Gashti SN, Griffin CR, Smith ND et al: Which is the most important risk factor for prostate cancer: race, family history, or baseline PSA level? J Urol, suppl., 2008; 179: 148, abstract 417. [link]
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