We evaluated differences in the prostate cancer detection rate among black and white men with serum prostate specific antigen (PSA) levels between 2.6 and 4.0 ng./ml., and benign findings on digital rectal examination.
From May 1995 through June 1997 we screened 14,209 white and 1,004 black men 50 years old or older with serum PSA and rectal examinations at 6-month intervals.
If PSA was greater than 2.5 ng./ml. or the rectal examination was suspicious for cancer, we recommended an ultrasound guided sextant biopsy of the prostate.
We compared differences in clinical characteristics, compliance with the recommendation for biopsy, cancer detection rate, and stage and grade of tumors detected for 924 white and 57 black men.
Black men were younger (60 versus 63 years old, p=0.005) and presented with slightly higher PSA levels (3.3 versus 3.1 ng./ml., p=0.03) than white men.
Overall cancer detection rate was 27% (106 of 391 patients), with cancer detection 2-fold higher among black (13 of 29,45%) than among white (93 of 362,26%) men (p=0.03, odds ratio 2.4,95% confidence interval 1.1 to 5.1).
Controlling for age, total PSA, PSA density, percent free PSA and number of prior screening visits, race remained a significant predictor of cancer (adjusted odds ratio 3.4, confidence interval 1.4 to 8.4).
We found trends for worse pathological stage and grade among black men but these differences did not reach statistical significance. (...)
Mots-clés Pascal : Adénocarcinome, Prostate, Antigène spécifique prostate, Marqueur tumoral, Toucher rectal, Etude comparative, Exploration, Dépistage, Adulte, Homme, Mâle, Ethnie, Etats Unis, Amérique du Nord, Amérique, Mongoloïde, Négroïde, Tumeur maligne, Appareil urinaire pathologie, Appareil génital mâle pathologie, Prostate pathologie
Mots-clés Pascal anglais : Adenocarcinoma, Prostate, Prostate specific antigen, Tumoral marker, Rectal touch, Comparative study, Exploration, Medical screening, Adult, Human, Male, Ethnic group, United States, North America, America, Mongoloid, Negroid, Malignant tumor, Urinary system disease, Male genital diseases, Prostate disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0499986
Code Inist : 002B14D02. Création : 19/02/1999.