Pathology of premalignant lesions and carcinoma of the prostate in African-American men.
The objective of this study was to summarize data describing the morphological characteristics of the spectrum of prostatic neoplasia in African-American men and compare them to their equivalents in Caucasian men. Studies that have emphasized the documentation of pathological features of prostate cancer or its putative precursors in African Americans are reviewed and are contrasted with comparable data concerning Caucasians. The author's experience is also presented. There is significant overlap between the pathological features of prostate cancer in African Americans and Caucasians in their clinical associations. The main pathological parameter reported with consistency to differ between the two groups is the observation that African-American patients present with a more advanced stage of the disease compared with Caucasian patients. Reports on differences in the grade and volume of the disease are less consistent. Comparative data on "preclinical," autopsy-type cancers and those concerning premalignant lesions indicate a similar prevalence of autopsy cancers between the two races while the prevalence and extent of high-grade prostatic intraepithelial neoplasia is higher in African-American men compared with Caucasian men. The difference is more evident in younger individuals. In conclusion, there are indications that African-American men with clinically localized prostate cancer tend to have a more advanced pathological stage at the time of radical prostatectomy compared with Caucasian men. Our data also indicate a higher prevalence of a putative precursor for clinically evident prostate cancer, high-grade prostatic intraepithelial neoplasia in African-American men. The earlier onset and extensiveness of this lesion may contribute to the higher incidence of clinically evident prostate cancer in African Americans.
Sakr
W A
WA
Department of Pathology, Harper Hospital, Wayne State University, Detroit, MI 48201, USA.
Grignon
D J
DJ
Haas
G P
GP
D000230:Adenocarcinoma / Q000208:ethnology* / Q000473:pathology*; D044383:Black People; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D011470:Prostatic Hyperplasia / Q000208:ethnology / Q000473:pathology; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000473:pathology*; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American