title: Racial differences in longitudinal changes in serum prostate-specific antigen levels: the Olmsted County Study and the Flint Men's Health Study.
abstract: OBJECTIVE
  To determine the distribution of, and racial differences in, changes in prostate-specific antigen (PSA) from a population-based sample of men.
  
  
  METHODS
  Data from 2 prospective cohort studies of a random sample of white men, aged 40-79 years in 1990, followed biennially through 2007, and African American men, aged 40-79 years in 1996, followed through 2000, were examined to assess the longitudinal changes in PSA concentrations. Serum PSA levels were determined at each examination for both cohorts and observations after a diagnosis of prostate cancer or treatment of benign prostatic hyperplasia were censored. The observed and estimated annual percentage of change in the serum PSA levels were examined by race.
  
  
  RESULTS
  At baseline, the median PSA level in the white men did not differ from the median level observed in the African American men (white men 0.9 ng/mL; African American men 0.9 ng/mL; P = .48). However, African American men had a much more rapid increase in the PSA level over time compared with the white men (median annual percent change in PSA for white men 3.6%/y, African American men 7.9%/y; P <.001).
  
  
  CONCLUSIONS
  These data suggest that African American men have more rapid rates of change in the PSA levels over time. If the difference in the rate of changes between African American and white men is an early indicator of future prostate cancer diagnosis, earlier detection in African American men could help to alleviate the racial disparities in prostate cancer diagnosis and mortality.
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI. Electronic address: asarma@umich.edu.
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Sarma
authors.affiliation: Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: St Sauver
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Jacobson
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Michaela E
authors.initials: ME
authors.lastname: McGree
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: George G
authors.initials: GG
authors.lastname: Klee
authors.affiliation: Department of Urology, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lieber
authors.affiliation: Comparative and Outcomes Evidence Unit, Merck Research Laboratories, Blue Bell, PA.
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Girman
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI.
authors.forename: John M
authors.initials: JM
authors.lastname: Hollingsworth
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente, Southern California, Pasadena, CA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D044465:White People
chemical_list: D017430:Prostate-Specific Antigen