Emergence of precision medicine has shaped the way we diagnose and manage patients with prostate cancer. The use of novel genomic biomarkers alongside existing clinical risk classifiers such as NCCN based categories has improved prostate cancer risk stratification and outcome prediction. However, lack of racial diversity in the studies that developed these prognostic biomarkers limits clinical utility of existing biomarkers across subpopulation. This study clearly shows that self-identified Black men classified as being low risk with standard NCCN based risk criteria may harbor genomically aggressive disease. Considering that current recommendations for active surveillance are based on NCCN risk criteria, it is vital to understand the genomic risk of prostate cancer within the subset of patients eligible for active surveillance who are more likely to experience adverse outcomes due to their underlying genomic risk.
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