Midlife PSA Predicts Aggressive Prostate Cancer in Black Men
Findings suggest potential for a targeted screening approach based on midlife PSA
THURSDAY, Oct. 11, 2018 (HealthDay News) -- Midlife levels of prostate-specific antigen (PSA) strongly predict future development of aggressive prostate cancer among black men, according to a study published online Sept. 17 in European Urology.
Mark A. Preston, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues assessed whether baseline PSA level during midlife predicts risk for aggressive prostate cancer among black men participating in the Southern Community Cohort Study (2002 to 2009). Analysis included 197 incident prostate cancer patients (aged 40 to 64 years at study entry) and 569 controls matched for age, date of blood draw, and site of enrollment. Blood samples collected and stored at enrollment were used to measure total PSA.
The researchers found that 95 percent of all cases and 97 percent of aggressive cases had baseline PSA above the age-specific median. For PSA >90th percentile, the odds ratio for total prostate cancer was 83.6 for 40- to 54-year-olds and 71.7 for 55- to 64-year-olds. Similarly, for aggressive cancer, odds ratios were 174.0 for 40- to 54-year-olds and 51.8 for 55- to 64-year-olds.
"Targeted screening based on a midlife PSA might identify men at high risk while minimizing screening in those men at low risk," the authors write.
Several authors disclosed financial ties to the diagnostics industry.