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

hasizes that "the criteria physicians use to define very-low-risk prostate cancer works well in whites this makes sense, since the studies used to validate the commonly used risk classification systems are largely based on white men." But, he adds, "Among the vast majority of African-American males with very-low-risk cancer who underwent surgical removal of the prostate, we discovered that they face an entirely different set of risks."

"Alternate race-specific surveillance entry criteria should be developed and utilized for African-American men to ensure oncologic parity with their white counterparts. Our research team, in collaboration with the internationally recognized Hopkins pathologist Dr. Jonathan Epstein, is currently developing new race-based risk tables that begin to solve this key issue," adds Schaeffer.

All of the men whose records were analyzed for the current study were selected from a group of 19,142 who had surgery at The Johns Hopkins Hospital between 1992 and 2012 to remove the prostate gland and some of the tissue around it.

Previous published research, Schaeffer says, revealed significant racial disparities in prostate cancer, with African-Americans having a much higher incidence of death from the disease than Caucasian men. According to the National Cancer Institute, black men have considerably higher incidence rates (236 cases per 100,000 from 2005 to 2009) than white men (146.9 cases per 100,000 per 2005 to 2009). The reasons for this are unclear.

"In the laboratory, we are developing new strategies to more accurately risk-classify African-Americans with newly diagnosed prostate cancer, in order to determine whether a patient should undergo active surveillance or have immediate treatment," says Schaeffer. "And we are beginning to work out the science behind why prostate cancers have a tendency to hide out in the anterior prostate, specifically in African-Americans."

Schaeffer says the main limit
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Contact: John Lazarou
jlazaro1@jhmi.edu
410-502-8902
Johns Hopkins Medicine
Source:Eurekalert

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