Prostate specific antigen remains an independent predictor of cancer at prostate biopsy in black american men but not in white men: results from a consecutive series of 914 men.
OBJECTIVE
Black American men may be at increased risk for prostate cancer but differences in prebiopsy parameters between black and white men have not been fully examined. Therefore, we identified the prebiopsy parameters that may be predictive of prostate cancer in black and white men.


METHODS
From January 2000 to July 2004, 914 consecutive men undergoing prostate needle biopsy were prospectively examined by a single urologist. Urinary symptoms were measured by AUASS. Prebiopsy parameters recorded were PSA, free PSA, DRE, age, race, biopsy history, prostate volume, TRUS lesion and AUASS.


RESULTS
Prostate biopsy was performed in 914 men with a mean age of 63.9 years. Mean PSA in the entire cohort was 11.2 ng/ml (median 5.8). Abnormal TRUS and abnormal DRE were found in 37% and 52% of men, respectively. Mean AUASS was 9.6. The overall positive biopsy rate was 37%. In black and white men the positive biopsy rate was 44% and 34%, respectively. Analysis of AUASS indicated that 47% of patients had low symptom scores (less than 7), 39% had moderate scores (8 to 19) and 14% had severe scores (20 to 35). Multivariate analysis revealed that PSA was an independent predictor of positive biopsy in black but not in white men (p = 0.001 and 0.79, respectively). Multivariate analysis also showed that race alone was an independent predictor of positive prostate biopsy (p = 0.013).


CONCLUSIONS
PSA remains an independent predictor of positive prostate biopsy on multivariate analysis. Other independent predictors are black race, age, low AUASS, prostate volume, abnormal DRE, no previous biopsy and abnormal TRUS. In the black group low AUASS, PSA, no previous biopsy and DRE were unique independent predictors, while in the white group age and abnormal TRUS were unique predictors.
Department of Urology, Virginia Mason Medical Center, Seattle, Washington, 98101, USA. klatchamsetty@yahoo.com
Kalyan C
KC
Latchamsetty
Jason
J
Kim
Christopher R
CR
Porter
D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000208:ethnology / Q000473:pathology*; D044465:White People
D017430:Prostate-Specific Antigen