Differences in prostate cancer detection between Canadian and Saudi populations.

Area of Science:

• Urology
• Oncology
• Epidemiology

Background:

• Prostate cancer (PCa) prevalence is lower in Arabic populations than Western ones, with limited research explaining this disparity.
• Serum prostate-specific antigen (PSA) is a key biomarker for PCa detection, but its interpretation may need ethnic-specific adjustments.
• Understanding racial variations in PCa detection is crucial for refining diagnostic strategies.

Purpose of the Study:

• To investigate and compare prostate cancer detection rates between Canadian and Saudi populations.
• To analyze racial differences in serum PSA, prostate volume, and PSA density.
• To identify demographic and clinical factors influencing PCa detection across different ethnicities.

Main Methods:

• Retrospective analysis of prospectively collected data from urology clinics at McGill University Health Center (MUHC) and King Saud University Hospital (KSUH).
• Inclusion criteria: men with high (>4 ng/mL) or rising PSA levels and a negative digital rectal examination.
• Comparison of demographic, clinical, and biomarker data between Canadian (n=717) and Saudi (n=158) patient cohorts.

Main Results:

• Significant differences observed in median serum PSA, prostate volume, and PSA density between MUHC and KSUH patients (P<0.0001).
• The Saudi (KSUH) cohort exhibited a significantly lower PCa detection rate, especially in men younger than 60 with PSA <10 ng/mL.
• Canadian patients had higher median PSA and prostate volume but lower PSA density compared to Saudi patients.

Conclusions:

• Racial variations in prostate cancer detection rates and biomarker values exist between Canadian and Saudi men.
• The study highlights the need for ethnicity-specific reference ranges or interpretation guidelines for PSA in PCa screening.
• Further research is warranted to elucidate the underlying biological and environmental factors contributing to these observed racial differences in PCa.