PSA levels accurately predict prostate cancer risk in African-American men

PHILADELPHIA – PSA levels appear to be more predictive of three year prostate cancer risk in African-American men compared with Caucasian men with a family history of prostate cancer, according to a paper published in Cancer Prevention Research, a journal of the American Association for Cancer Research.

"It was previously thought that PSA levels were just naturally higher in African-American men, suggesting a need to possibly adjust the threshold upward before recommending a biopsy," said Veda Giri, M.D., director of the Prostate Cancer Risk Assessment Program at Fox Chase Cancer Center.

Giri and colleagues at the University of Chicago observed 646 high-risk men, of whom 63 percent were African-American, in the Prostate Cancer Risk Assessment Program, which has an aggressive early detection approach.

No "race specific" differences in PSA levels were found when race was measured using genetic markers of ancestry or reported by participants.

The researchers subsequently analyzed men with a PSA between 1.5 to 4 ng/mL, and who had at least one follow-up visit. They found that among men with a family history of prostate cancer, PSA levels had the same predictive value whether the men were Caucasian or African-American.

These findings are unique in that typically men are not recommended for a prostate biopsy until their PSA levels rise above 4 ng/mL. Larger studies with longer follow-up are needed to confirm these findings.

"African-American men and men with a family history of prostate cancer should be encouraged to participate in early detection studies to define personalized screening strategies that may diagnose prostate cancer at a curable point," said Giri.