Impact of race in using PSA velocity to predict for prostate cancer

To assess whether race is a significant factor in the ability of prostate-specific antigen velocity (PSAV) for predicting high-grade prostate cancer (HGPC).

Records of men who underwent prostate biopsy between January 2003 and December 2007 were retrospectively reviewed to collect demographic data, self-reported race, prostate-specific antigen (PSA) data, and pathology results. PSAV was calculated using linear regression. Subjects were stratified by the presence or absence of HGPC. Median PSA and PSAV values were compared within each racial group using receiver operating characteristic analysis and Student t test.

Static PSA was significantly higher in Caucasian men with HGPC (4.81 vs. 8.3 ng/mL, p = 0.0000001) while PSAV was also higher in men with HGPC (0.639 vs. 1.15 ng/mL/yr, p = 0.081). Static PSA in Asians did not perform well in predicting HGPC (5.3 vs. 9.42 ng/mL, p = 0.11), but fared much better than PSAV (0.51 vs. 0.93 ng/mL/yr, p = 0.27). PSA in African Americans did not significantly predict HGPC (6.27 vs. 7.7 ng/mL, p = 0.474), but PSAV showed a stronger trend toward significance (0.615 vs. 1.54 ng/mL/yr, p = 0.068).

PSAV may complement static PSA in African Americans and help identify early stage aggressive cancers.