The majority of men diagnosed with prostate cancer in the PSA-screening era are eligible
for active surveillance and is often the initial therapy in men with low-risk prostate
cancer. Active surveillance may reduce unnecessary treatments for patients without
increasing risk of prostate cancer mortality.
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However, Black men represented only 7%-13% in these prospective cohort studies. Compared
to White men, it has been previously shown that Black men have an increased prostate
cancer incidence, higher baseline prostate-specific antigen value, more aggressive
prostate cancer features, greater frequency of biochemical recurrence after treatment,
and higher overall cancer-specific mortality. Thus, this has given many physicians
pause before initiating active surveillance.To read this article in full you will need to make a payment
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References
- 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.N Engl J Med. 2016; 375: 1415-1424
- Intermediate and Longer-Term Outcomes From a Prospective Active-Surveillance Program for Favorable-Risk Prostate Cancer.J Clin Oncol. 2015; 33: 3379-3385
- Active surveillance for favorable-risk prostate cancer: who, how and why?.Nature Clinical Practice Oncology. 2007; 4: 692-698https://doi.org/10.1038/ncponc0966
- Income inequality and treatment of African American men with high-risk prostate cancer.Urologic Oncology: Seminars and Original Investigations. 2015; 33 (18.e7-e18.e13)https://doi.org/10.1016/j.urolonc.2014.09.005
- Commercial Gene Expression Tests for Prostate Cancer Prognosis Provide Paradoxical Estimates of Race-Specific Risk.Cancer Epidemiol Biomarkers Prev. 2020; 29: 246-253
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