Clinical characteristics in black and white men with prostate cancer in anequal access medical center

Objectives. To determine whether black men with newly diagnosed prostate ca ncer in an equal access hearth care center are more likely to present with metastatic disease, more poorly differentiated tumors, higher serum prostat e-specific antigen (PSA) levels, and/or at younger ages compared with white men. Methods. A retrospective survey was conducted that identified black and whi te men with newly diagnosed prostate cancer at the Los Angeles Regional Vet erans Affairs Clinics between 1991 and 1997. Patient data were analyzed for racial differences in age at diagnosis, clinical stage, PSA level, and Gle ason score of the prostate biopsy specimens. Results. A total of 477 evaluable patients (230 black, 247 white) with newl y diagnosed prostate cancer were identified. No significant differences in the average age (66.9 +/- 7.5 versus 67.9 +/- 7.5) or clinical stage at dia gnosis were found between black and white men. Among black men, 87% present ed with clinically localized disease (Tl-2, Nx, MO) compared with 88% of wh ite men. Only 6% of black men presented with distant disease (Tx, Nx, Mi) c ompared with 4% of white men. Black men had higher median PSA levels than w hite men (14.2 versus 9.4 ng/mL, P = 0.0001). Black men also had slightly h igher average Gleason scores (6.2 Versus 5.9, P = 0.025). Conclusions. This is the first study to show a low and equal percentage of black and white men presenting with metastatic prostate cancer. In this equ al access center, no differences were found in patient age or clinical stag e of prostate cancer between black and white men at the time of diagnosis. However, black men presented with higher serum PSA values and slightly high er Gleason scores. (C) 2000, Elsevier Science Inc.