Evaluating Prostate-Specific Antigen Screening for Young African American Men With Cancer

Qiao, Edmund M.; Lynch, Julie; Lee, Kyung M.; Kotha, Nikhil V.; Nalawade, Vinit; Voora, Rohith S.; Qian, Alexander S.; Nelson, Tyler J.; Yamoah, Kosj; Garraway, Isla P.; Stewart, Tyler F.; Parsons, J. Kellogg; Rose, Brent S.

doi:10.1093/jnci/djab221

Cited by 7 publications

(9 citation statements)

References 28 publications

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“…Survival times were adjusted by withholding estimated lead times for each patient during analysis. 6,9 Missing values were binned into unknown (categorical) or were imputed with the median (continuous). Sensitivity analyses assessed the effects of limiting the study population to age 60 to 69 years and of removing nonsignificant variables from multivariable models.…”

Section: Methodsmentioning

confidence: 99%

“…4 Prostate-specific antigen screening among Black men may be associated with reductions in these disparities in mortality. 5,6 However, more data on screening are needed to develop appropriate, personalized recommendations for Black men. 7 Our objective was to investigate whether previous PSA screening was associated with decreased PCSM risk among non-Hispanic Black men and non-Hispanic White men with prostate cancer in a racially diverse cohort of US veterans.…”

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confidence: 99%

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Association Between Prostate-Specific Antigen Screening and Prostate Cancer Mortality Among Non-Hispanic Black and Non-Hispanic White US Veterans

et al. 2022

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ImportanceBlack men have higher prostate cancer incidence and mortality than non-Hispanic White men. However, Black men have been underrepresented in clinical trials of prostate-specific antigen (PSA) screening; thus, there is a lack of data to guide screening recommendations for this population.ObjectiveTo assess whether PSA screening is associated with reduced risk of prostate cancer–specific mortality (PCSM) among non-Hispanic Black men.Design, Setting, and ParticipantsThis retrospective cohort study used data from the US Veterans Health Administration Informatics and Computing Infrastructure for men aged 55 to 69 years who self-identified as non-Hispanic Black or non-Hispanic White and were diagnosed with intermediate-, high-, or very high–risk prostate cancer from January 1, 2004, to December 31, 2017. Data were analyzed from August 2021 to March 2022.ExposuresProstate-specific antigen screening rate, defined as the percentage of years in which PSA screening was conducted during the 5 years before diagnosis of prostate cancer.Main Outcomes and MeasuresThe primary outcome was risk of PCSM among Black men and White men. The association between PSA screening and risk of PCSM was assessed using Fine-Gray regression analysis. Risk of PCSM was also assessed categorically among patients classified as having no prior PSA screening, some screening (less than annual), or annual screening in the 5 years before diagnosis.ResultsThe study included 45 834 veterans (mean [SD] age, 62.7 [3.8] years), of whom 14 310 (31%) were non-Hispanic Black men and 31 524 (69%) were non-Hispanic White men. The PSA screening rate was associated with a lower risk of PCSM among Black men (subdistribution hazard ratio [sHR], 0.56; 95% CI, 0.41-0.76; P = .001) and White men (sHR, 0.58; 95% CI, 0.46-0.75; P = .001). On subset analysis, annual screening (vs some screening) was associated with a significant reduction in risk of PCSM among Black men (sHR, 0.65; 95% CI, 0.46-0.92; P = .02) but not among White men (sHR, 0.91; 95% CI, 0.74-1.11; P = .35).Conclusions and RelevanceIn this cohort study, PSA screening was associated with reduced risk of PCSM among non-Hispanic Black men and non-Hispanic White men. Annual screening was associated with reduced risk of PCSM among Black men but not among White men, suggesting that annual screening may be particularly important for Black men. Further research is needed to identify appropriate populations and protocols to maximize the benefits of PSA screening.

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Section: Methodsmentioning

confidence: 99%

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Association Between Prostate-Specific Antigen Screening and Prostate Cancer Mortality Among Non-Hispanic Black and Non-Hispanic White US Veterans

et al. 2022

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“…This method has been previously described. 8 , 9 PCP visits prior to cancer diagnosis were binned into none (0 visits), some (1-4 visits), and annual (5 visits).…”

Section: Methodsmentioning

confidence: 99%

Association Between Primary Care Use Prior to Cancer Diagnosis and Subsequent Cancer Mortality in the Veterans Affairs Health System

et al. 2022

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ImportancePrimary care physicians (PCPs) are significant contributors of early cancer detection, yet few studies have investigated whether consistent primary care translates to improved downstream outcomes.ObjectiveTo evaluate the association of prediagnostic primary care use with metastatic disease at diagnosis and cancer-specific mortality (CSM).Design, Setting, and ParticipantsThis cohort study used databases with primary care and referral linkage from multiple Veterans’ Affairs centers from 2004 to 2017 and had a 68-month median follow-up. Analysis was completed between July 2021 and September 2022. Participants included veterans older than 39 years who had been diagnosed with 1 of 12 cancers. Inclusion criteria included known clinical staging, survival follow-up, cause of death, and receiving care at the Veterans Affairs health system (VA).ExposuresPrediagnostic PCP use, measured in the 5 years prior to diagnosis. PCP visits were binned into none (0 visits), some (1-4 visits), and annual (5 visits).Main Outcomes and MeasuresMetastatic disease at diagnosis, cancer-specific mortality (CSM) for entire cohort and stratified by tumor subtype.ResultsAmong 245 425 patients representing 12 tumor subtypes, mean age was 65.8 (9.3) years, and the cohort skewed male (97.6%), and White (76.1%), with higher levels of comorbidity (58.6% with Charlson Comorbidity Index scores ≥2). Compared with no prior visit, some PCP use was associated with 26% decreased odds of metastatic disease at diagnosis (odds ratio [OR], 0.74; 95% CI, 0.71-0.76; P &lt; .001) and 12% reduced risk of CSM (subdistribution hazard ratio [SHR], 0.88; 95% CI, 0.86-0.89; P &lt; .001). Annual PCP use was associated with 39% decreased odds of metastatic disease (OR, 0.61; 95% CI, 0.59-0.63; P &lt; .001) and 21% reduced risk of CSM (SHR, 0.79; 95% CI, 0.77-0.81; P &lt; .001). Among tumor subtypes, prostate cancer had the largest effect size for prior PCP use on metastatic disease at diagnosis (OR for annual use, 0.32; 95% CI, 0.30-0.35; P &lt; .001) and CSM (SHRfor annual use, 0.51; 95% CI, 0.48-0.55; P &lt; .001).Conclusions and RelevanceIn this cohort study, increased primary care use before cancer diagnosis was associated with significant decreases in metastatic disease at diagnosis and cancer-related death, with potentially the greatest difference from annual use. PCPs play a vital role in cancer prevention, and additional resources should be allocated to assist these physicians.

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“…In just a short time, the POPCaP group has published several papers regarding racial disparities in prostate cancer outcomes, radiation effectiveness, and prostate-specific antigen (PSA)-screening effectiveness. [63][64][65][66] Future studies will utilize nested subcohorts of Veterans with access to somatic next-generation sequencing data, molecular data from tumor specimens, and data from the Million Veteran Program, 67 which links survey data with genotyping, whole-exome sequencing, and whole-genome sequencing data. This "mega-repository," launched in 2011, will enable the study of genotype-lifestyle-exposure correlations at a scale never before done in prostate cancer.…”

Section: St Century Responsible Speeding Of New Treatments To Patientsmentioning

confidence: 99%

“…The VA population is unique because of the high prevalence of prostate cancer (7%) and the high proportion of Black patients relative to the national population. In just a short time, the POPCaP group has published several papers regarding racial disparities in prostate cancer outcomes, radiation effectiveness, and prostate‐specific antigen (PSA)‐screening effectiveness 63–66 . Future studies will utilize nested subcohorts of Veterans with access to somatic next‐generation sequencing data, molecular data from tumor specimens, and data from the Million Veteran Program, 67 which links survey data with genotyping, whole‐exome sequencing, and whole‐genome sequencing data.…”

Section: St Century Responsible Speeding Of New Treatments To Patientsmentioning

confidence: 99%

Exploring new frontiers in prostate cancer research: Report from the 2022 Coffey−Holden prostate cancer academy meeting

et al. 2022

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Introduction The 2022 Coffey−Holden Prostate Cancer Academy (CHPCA) Meeting, “Exploring New Frontiers in Prostate Cancer Research,” was held from June 23 to 26, 2022, at the University of California, Los Angeles, Luskin Conference Center, in Los Angeles, CA. Methods The CHPCA Meeting is an annual discussion‐oriented scientific conference organized by the Prostate Cancer Foundation, that focuses on emerging and next‐step topics deemed critical for making the next major advances in prostate cancer research and clinical care. The 2022 CHPCA Meeting included 35 talks over 10 sessions and was attended by 73 academic investigators. Results Major topic areas discussed at the meeting included: prostate cancer diversity and disparities, the impact of social determinants on research and patient outcomes, leveraging real‐world and retrospective data, development of artificial intelligence biomarkers, androgen receptor (AR) signaling biology and new strategies for targeting AR, features of homologous recombination deficient prostate cancer, and future directions in immunotherapy and nuclear theranostics. Discussion This article summarizes the scientific presentations from the 2022 CHPCA Meeting, with the goal that dissemination of this knowledge will contribute to furthering global prostate cancer research efforts.

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Evaluating Prostate-Specific Antigen Screening for Young African American Men With Cancer

Cited by 7 publications

References 28 publications

Association Between Prostate-Specific Antigen Screening and Prostate Cancer Mortality Among Non-Hispanic Black and Non-Hispanic White US Veterans

Association Between Prostate-Specific Antigen Screening and Prostate Cancer Mortality Among Non-Hispanic Black and Non-Hispanic White US Veterans

Association Between Primary Care Use Prior to Cancer Diagnosis and Subsequent Cancer Mortality in the Veterans Affairs Health System

Exploring new frontiers in prostate cancer research: Report from the 2022 Coffey−Holden prostate cancer academy meeting

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