Racial Disparity May Exist in Prostate Cancer Prognosis

Black men diagnosed with prostate cancer classified as low risk may actually have a more aggressive form of the disease that is more likely to be fatal than in nonblack men placed in the same prognostic category, a new study suggests. This disparity emerged from research led by a Dana-Farber Cancer Institute scientist and published as a report in JAMA. The study analyzed databases of hundreds of thousands of men diagnosed with prostate cancer and assigned a Gleason score on the basis of a biopsy and examination of samples of cancer under a microscope. Gleason scores range from 6 to 10, with higher numbers (7-10) indicating greater risk and higher mortality. The study findings focused on men who were classified as Gleason 6, which signifies a favorable prognosis with a low risk of death, and 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.