title: Race, genetic West African ancestry, and prostate cancer prediction by prostate-specific antigen in prospectively screened high-risk men.
abstract: "Race-specific" prostate-specific antigen (PSA) needs evaluation in men at high risk for prostate cancer for optimizing early detection. Baseline PSA and longitudinal prediction for prostate cancer were examined by self-reported race and genetic West African (WA) ancestry in the Prostate Cancer Risk Assessment Program, a prospective high-risk cohort. Eligibility criteria were age 35 to 69 years, family history of prostate cancer, African American race, or BRCA1/2 mutations. Biopsies were done at low PSA values (<4.0 ng/mL). WA ancestry was discerned by genotyping 100 ancestry informative markers. Cox proportional hazards models evaluated baseline PSA, self-reported race, and genetic WA ancestry. Cox models were used for 3-year predictions for prostate cancer. Six hundred forty-six men (63% African American) were analyzed. Individual WA ancestry estimates varied widely among self-reported African American men. Race-specific differences in baseline PSA were not found by self-reported race or genetic WA ancestry. Among men with > or =1 follow-up visit (405 total, 54% African American), 3-year prediction for prostate cancer with a PSA of 1.5 to 4.0 ng/mL was higher in African American men with age in the model (P = 0.025) compared with European American men. Hazard ratios of PSA for prostate cancer were also higher by self-reported race (1.59 for African American versus 1.32 for European American, P = 0.04). There was a trend for increasing prediction for prostate cancer with increasing genetic WA ancestry. "Race-specific" PSA may need to be redefined as higher prediction for prostate cancer at any given PSA in African American men. Large-scale studies are needed to confirm if genetic WA ancestry explains these findings to make progress in personalizing prostate cancer early detection.
authors.affiliation: Division of Population Sciences and Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA. Veda.Giri@fccc.edu
authors.forename: Veda N
authors.initials: VN
authors.lastname: Giri
authors.forename: Brian
authors.initials: B
authors.lastname: Egleston
authors.forename: Karen
authors.initials: K
authors.lastname: Ruth
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
authors.forename: David Y T
authors.initials: DY
authors.lastname: Chen
authors.forename: Mark
authors.initials: M
authors.lastname: Buyyounouski
authors.forename: Susan
authors.initials: S
authors.lastname: Raysor
authors.forename: Stanley
authors.initials: S
authors.lastname: Hooker
authors.forename: Jada Benn
authors.initials: JB
authors.lastname: Torres
authors.forename: Teniel
authors.initials: T
authors.lastname: Ramike
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mastalski
authors.forename: Taylor Y
authors.initials: TY
authors.lastname: Kim
authors.forename: Rick
authors.initials: R
authors.lastname: Kittles
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001706:Biopsy; D044383:Black People; D055088:Early Detection of Cancer; D005006:Ethnicity; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000096:biosynthesis*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D012306:Risk
chemical_list: D017430:Prostate-Specific Antigen