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'Active surveillance' may miss aggressive prostate cancers in black men
Date:6/25/2013

A Johns Hopkins study of more than 1,800 men ages 52 to 62 suggests that African-Americans diagnosed with very-low-risk prostate cancers are much more likely than white men to actually have aggressive disease that goes unrecognized with current diagnostic approaches. Although prior studies have found it safe to delay treatment and monitor some presumably slow-growing or low-risk prostate cancers, such "active surveillance" (AS) does not appear to be a good idea for black men, the study concludes.

"This study offers the most conclusive evidence to date that broad application of active surveillance recommendations may not be suitable for African-Americans," says urologist Edward M. Schaeffer, M.D., Ph.D., a co-author of the study. "This is critical information because if African-American men do have more aggressive cancers, as statistics would suggest, then simply monitoring even small cancers that are very low risk would not be a good idea because aggressive cancers are less likely to be cured," he says. "We think we are following a small, nonaggressive cancer, but in reality, this study highlights that in black men, these tumors are sometimes more aggressive than previously thought. It turns out that black men have a much higher chance of having a more aggressive tumor developing in a location that is not easily sampled by a standard prostate biopsy."

A report of the study, posted online and ahead of the print version in the Journal of Clinical Oncology, describes it as the largest analysis of potential race-based health disparities among men diagnosed with a slow-growing, very nonaggressive form of prostate cancer.

The Johns Hopkins study also showed that the rate of increased pathologic risk, as measured by the Cancer of the Prostate Risk Assessment (CAPRA), was also significantly higher in African-Americans (14.8 percent vs. 6.9 percent). The 12-point CAPRA score is an accepted predictor of biochemical disease recurrenc
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Contact: John Lazarou
jlazaro1@jhmi.edu
410-502-8902
Johns Hopkins Medicine
Source:Eurekalert

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