title: Reducing prostate cancer racial disparity: evidence for aggressive early prostate cancer PSA testing of African American men.
abstract: BACKGROUND
  There is continuing controversy about prostate cancer testing and the recent American Urological Association guidelines. We hypothesize that the reduction and elimination of racial survival disparity among African American men (AAM; high-risk group) compared with European American men (EAM; intermediate-risk group) during the PSA testing era compared with the pre-PSA era strongly supports the use of PSA testing in AAM.
  
  
  METHODS
  We used Surveillance, Epidemiology, and End Results (SEER) data to investigate relative survival disparities between AAM and EAM. To evaluate pre-PSA testing era, we selected malignant first primary prostate cancer in AAM and EAM, all stages, diagnosed during 1973-1994. To evaluate relative survival disparities in the current PSA testing era, we selected malignant first primary local, regional, and distant stage prostate cancers diagnosed during 1998-2005 to calculate 5-year relative survival rates.
  
  
  RESULTS
  Age-adjusted 5-year relative survival of prostate cancer diagnosed during 1973-1994 in the national SEER data revealed significantly shorter survival for AAM compared with EAM (P < 0.0001). The SEER-based survival analysis from 1995 to 2005 indicated no statistical difference in relative survival rates between AAM and EAM by year of diagnosis of local, regional, or distant stage prostate cancer.
  
  
  CONCLUSIONS
  We conclude that the elimination of prostate cancer racial disparity of local, regional, and metastatic prostate cancer relative survival in the current PSA testing era compared with pre-PSA era as an endpoint to test PSA efficacy as a marker for prostate cancer diagnosis is evidence for aggressive testing of AAM.
  
  
  CONCLUSIONS
  Evidence for screening AAM.
authors.affiliation: Wayne State University; and Karmanos Cancer Institute, Detroit, Michigan ipowell@med.wayne.edu.
authors.forename: Isaac J
authors.initials: IJ
authors.lastname: Powell
authors.affiliation: Wayne State University; and Karmanos Cancer Institute, Detroit, Michigan.
authors.forename: Fawn D
authors.initials: FD
authors.lastname: Vigneau
authors.affiliation: Wayne State University; and Karmanos Cancer Institute, Detroit, Michigan.
authors.forename: Cathryn H
authors.initials: CH
authors.lastname: Bock
authors.affiliation: Wayne State University; and Karmanos Cancer Institute, Detroit, Michigan.
authors.forename: Julie
authors.initials: J
authors.lastname: Ruterbusch
authors.affiliation: Wayne State University; and Karmanos Cancer Institute, Detroit, Michigan.
authors.forename: Lance K
authors.initials: LK
authors.lastname: Heilbrun
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000208:ethnology*; D018426:SEER Program
chemical_list: D017430:Prostate-Specific Antigen