Newswire (Published: Thursday, December 27, 2018, 8:00:00 PM CST, Received: Thursday, December 27, 2018, 8:59:05 PM CST)
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This disparity emerged from research led by a
The study findings focused on men who were classified as Gleason 6, which signifies a favorable prognosis with a low risk of death, and a cancer that doesn't necessarily need to be treated - at least not immediately. Many men in this category, after a conversation with their doctor, adopt an "active surveillance" approach, which may include monitoring of PSA (prostate-specific antigen) levels, digital rectal exams, and repeated biopsies. If there is evidence the cancer is progressing, treatment may be warranted.
However, some men with Gleason 6 cancers opt for treatment rather than surveillance. "Data suggests that
The study found that the overall risk of prostate cancer death was not statistically significant between 31,841 black and 160,383 nonblack patients, after accounting for socioeconomic status and treatment patterns. But when the analysis focused on patients with Gleason grade 6 cancer, there were 51 deaths among 12,707 black patients (0.40 percent) versus 155 deaths among 70,938 nonblack patients (0.22 percent) at a median follow-up of 36 months. In other words, the death rate - while low - was almost double in the black men with Gleason 6 disease, even after accounting for socioeconomic status and treatment patterns.
The researchers did a similar analysis in a larger cohort of 62,736 black and 340,286 nonblack men who had been followed for a longer period. The 12-year prostate cancer mortality rate in patients with Gleason scores 7 to 12 was 5.5 percent in black men versus 5.3 percent in nonblacks. But again, a disparity appeared in Gleason 6 prostate cancers: the 12-year mortality rate was 2.2 percent in black patients versus 1.4 percent in nonblacks. This difference, the authors wrote, "support the hypothesis that low-grade prostate cancer may be distinct in black men."
Asked what the study results imply for clinical practice, Mahal said, "These data would be an impetus for randomized, prospective trials to both better characterize Gleason 6 disease in black men and to test different management strategies," i.e. immediate treatment versus active surveillance. He said that in
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