Active surveillance of slow-growing prostate cancer may be a bad idea for black men.
A Johns Hopkins study of more than 1,800
men ages 52 to 62 suggests that African-Americans diagnosed with
very-low-risk prostate cancers are much more likely than white men to
actually have aggressive disease that goes unrecognized with current
diagnostic approaches.
Prior studies found it safe to delay
treatment and monitor the slow-growing cancers, which is okay for white
men, but not a good idea for black men.
And yesterday Tara Soares, executive
director of Bermuda Cancer and Health, said that black Bermudian men
should be tested for the disease earlier than their white counterparts.
Ms Soares said: “There is a higher
incidence of prostate cancer being diagnosed in men of African descent
and we know that prostate cancer in that group does occur at an earlier
age.
“Men of African descent should start seeing their doctor at the age of 40 and have a test.”
Prostate cancer is the second-biggest
cause of cancer death in men after lung cancer, according to the US
Centres for Disease Control.
Urologist Dr Edward Schaeffer, a
co-author of the study, said: “This study offers the most conclusive
evidence to date that broad applications of active surveillance
recommendations may not be suitable for African-Americans.
“This is critical information because if
African American men do have more aggressive cancers, as statistics
would suggest, then simply monitoring even small cancers that are very
low risk would not be a good idea because aggressive cancers are less
likely to be cured.
“We think that we are following a small
non-aggressive cancer, but in reality, this study highlights that in
black men, these tumours are sometimes more aggressive than previously
thought.
“It turns out that black men have a much
higher chance of having a more aggressive tumour developing in a
location that is not easily sampled by a standard prostate biopsy.”
And Dr Schaeffer said: “Alternate
race-specific surveillance entry criteria should be developed and
utilized for African American men to ensure oncological parity with
their white counterparts.
Our research team, in collaboration with
internationally-recognised Hopkins pathologist Dr Jonathan Epstein, is
currently developing new race-based risk tables that begin to solve this
key issue.
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