Race and serum prostate-specific antigen levels: current status and future directions

Prostate cancer (PC) is a serious public health problem in the United States, especially in African-American men (AAs). AAs have higher incidence and mortality rates and present with higher stage and grade of PC than other racial/ethnic groups. Given the importance of serum prostate-specific antigen level (PSA) as a screening tool for PC and its prognostic value among patients with PC, exploring the relationship between PSA and race has gained enormous interest lately. The number of studies addressing such relationships has increased tremendously over the past few years. Most of these studies indicate a higher PSA in AAs than whites in men with or without PC even after adjustment for patients' age and prostate volume (in men without PC) and for PC grade and stage (in men with PC). The etiology of higher PSA levels in AAs is not completely understood and might be secondary to biological, environmental/socioeconomic reasons, or both. Studying serum PSA dynamics among AAs may help in elucidating the epidemiological features of PC in AAs.