Racial Differences in Longitudinal Changes in Serum Prostate-specific Antigen Levels: The Olmsted County Study and the Flint Men's Health Study
Sarma AV1, St Sauver JL2, Jacobson DJ3, McGree ME3, Klee GG4, Lieber MM5, Girman CJ6, Hollingsworth JM7, Jacobsen SJ8; Urologic Diseases in America Project. Urology. 2014 Jan;83(1):88-93. doi: 10.1016/j.urology.2013.08.025. Epub 2013 Oct 16.

Author information

1Department of Urology, University of Michigan, Ann Arbor, MI. Electronic address: asarma@umich.edu. 2Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, MN. 3Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN. 4Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN. 5Department of Urology, Mayo Clinic College of Medicine, Rochester, MN. 6Comparative and Outcomes Evidence Unit, Merck Research Laboratories, Blue Bell, PA. 7Department of Urology, University of Michigan, Ann Arbor, MI. 8Department of Research and Evaluation, Kaiser Permanente, Southern California, Pasadena, CA.

Abstract

OBJECTIVE: To determine the distribution of, and racial differences in, changes in prostate-specific antigen (PSA) from a population-based sample of men.

MATERIALS AND METHODS: Data from 2 prospective cohort studies of a random sample of white men, aged 40-79 years in 1990, followed biennially through 2007, and African American men, aged 40-79 years in 1996, followed through 2000, were examined to assess the longitudinal changes in PSA concentrations. Serum PSA levels were determined at each examination for both cohorts and observations after a diagnosis of prostate cancer or treatment of benign prostatic hyperplasia were censored. The observed and estimated annual percentage of change in the serum PSA levels were examined by race.

RESULTS: At baseline, the median PSA level in the white men did not differ from the median level observed in the African American men (white men 0.9 ng/mL; African American men 0.9 ng/mL; P = .48). However, African American men had a much more rapid increase in the PSA level over time compared with the white men (median annual percent change in PSA for white men 3.6%/y, African American men 7.9%/y; P <.001).

CONCLUSION: These data suggest that African American men have more rapid rates of change in the PSA levels over time. If the difference in the rate of changes between African American and white men is an early indicator of future prostate cancer diagnosis, earlier detection in African American men could help to alleviate the racial disparities in prostate cancer diagnosis and mortality.