Age-Dependent Occurrence of Prostate Cancer in an African-American Patient Population of Predominantly West Indian Origins

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Shabnam Seydafkan Hagar Atia Bo Lin Matthew R. Pincus

Abstract

In a prior study of the occurrence of prostate cancer in a unique population of African American patients many of whom have West Indian ancestry, we found that seventy percent of patients screened for prostate were found to have this disease and that, of the seventy percent diagnosed with prostate cancer, 70 percent were found to have high-grade (Gleason score ≥ 7) disease. Overall, therefore, high-grade prostate cancer was found in over 50 percent of all cancers diagnosed, a rate of occurrence that was significantly higher than the corresponding ones for other demographic populations. Since the average age for screening was 65, the same as in other demographic groups, we conjectured that earlier screening of our patients might eliminate many of these high-grade tumors. To validate this hypothesis, we have now examined the rates of occurrence of high-grade prostate cancers in successive age groups, i.e., 40-<50, 50-<60, 60-<70, 70-<80 and >80. Surprisingly, we found that, already in the 50-<60 age group, the frequency of occurrence of high-grade cancers is >50%. (The number of patients in the 40-<50, i.e.,12 and >80, i.e., 6, were too small to be accurately evaluated.) Since the high rate of high-grade cancer occurs in the 50-<60-year group, we conclude that screening for prostate cancer should be performed on our patients at significantly earlier ages such as 40-<50. Also, in view of the expectation that high-grade tumors would increase with increasing age, a second unexpected finding was that the percentage of high-grade tumors was statistically the same at >50 percent in the 50-<60, 60-<70 and 70-<80 age groups. This result could be explained if there was a concurrent increase in low-grade tumors occurring in older patients suggesting that continued, persistent screening is necessary even in advanced age groups. We further found that the mean Gleason score of the 50-<60 and 60-<70 age groups is statistically the same, suggesting that the high-grade tumors are "stable". However, there is a statistically significant increase in Gleason scores between the 70-<80 age group and the two lower age groups which is associated with a large increase in Gleason 9 cancers in the 70-<80 age group and a concurrent, marked decrease in Gleason 7 cancers, suggesting significant recurrent progression of high-grade tumors in this age group.

Article Details

How to Cite
SEYDAFKAN, Shabnam et al. Age-Dependent Occurrence of Prostate Cancer in an African-American Patient Population of Predominantly West Indian Origins. Medical Research Archives, [S.l.], v. 11, n. 8, aug. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4226>. Date accessed: 13 july 2024. doi: https://doi.org/10.18103/mra.v11i8.4226.
Section
Research Articles

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