Genetically adjusted prostate-specific antigen values may prevent delayed biopsies in African-American men

Area of Science:

• Genetics
• Urology
• Oncology

Background:

• Prostate cancer (PCa) disproportionately affects African-American men.
• Genetic variants in prostate-specific antigen (PSA)-single nucleotide polymorphisms (SNPs) may influence PSA levels.
• Current biopsy guidelines may not account for genetic variations.

Purpose of the Study:

• To evaluate if genetic correction of PSA-SNP variants could decrease unnecessary or delayed prostate cancer biopsies in African-American men.
• To compare the impact of PSA-SNP genotypes between African-American and Caucasian men.

Main Methods:

• Compared genotypes of four PSA-SNPs in 964 Caucasian and 363 African-American men without known PCa.
• Adjusted PSA values based on individual PSA-SNP carrier status.
• Calculated biopsy threshold adherence before and after genetic correction.

Main Results:

• Genetic correction did not avoid any potentially unnecessary biopsies in African-American men.
• A significant reduction (P < 0.001) in potentially delayed biopsies was observed: 2.5% for PSA ≥ 2.5 ng/mL and 3.9% for PSA ≥ 4.0 ng/mL.
• Significant differences in PSA-SNP influence were noted between African-American and Caucasian men.

Conclusions:

• Genetic correction of PSA-SNPs increased the proportion of African-American men crossing the biopsy threshold.
• These findings suggest genetic differences in PSA may contribute to delayed prostate cancer diagnosis in African-American men.
• Further research is needed to understand the role of genetic variations in PCa diagnosis for this population.