Ethnic differences in prostate cancer presentation: a time for testing advocacy

Area of Science:

• Urology
• Oncology
• Public Health

Background:

• Ethnic variations in prostate cancer (PCa) epidemiology impact outcomes.
• While South Asians (SA) are less frequently diagnosed with PCa, incidence is rising.
• Understanding these ethnic differences is crucial for effective PCa management.

Purpose of the Study:

• To examine ethnic differences in PCa presentation.
• To compare PCa progression risk across ethnicities.
• To assess prostate-specific antigen (PSA) testing utilization among different ethnic groups.

Main Methods:

• Retrospective study of 1176 biopsy-proven PCa patients in London.
• Patients grouped by ethnicity: South Asian, White, Black, and others.
• Comparison of presenting symptoms, PSA levels, Gleason score (GS), clinical stage, and D'Amico risk stratification.

Main Results:

• Black patients were diagnosed younger (65 ± 8.8 years).
• No significant ethnic differences in presenting PSA levels.
• South Asian men had the highest proportion of advanced Gleason scores (30.6%) and least PSA test-detected cancers (38%).
• 65-71% of patients across all ethnicities presented with high-risk D'Amico category disease.

Conclusions:

• Ethnic disparities exist in PCa diagnosis and presentation.
• South Asian men face a higher burden of advanced disease and lower PSA screening rates.
• Targeted public health interventions are needed to address ethnic variations in PCa and encourage PSA testing among South Asian men.