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Giri VN , Egleston B , Ruth K , Uzzo RG , Chen DY , Buyyounouski M , Raysor S , Hooker S , Torres JB , Ramike T , Mastalski K , Kim TY , Kittles R
Race, genetic West African ancestry, and prostate cancer prediction by prostate-specific antigen in prospectively screened high-risk men
Cancer Prev Res (Phila Pa). 2009 Mar;2(3) :244-50
PMID: 19240249    PMCID: PMC2652509   
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Abstract
"Race-specific" prostate-specific antigen (PSA) needs evaluation in men at high risk for prostate cancer for optimizing early detection. Baseline PSA and longitudinal prediction for prostate cancer were examined by self-reported race and genetic West African (WA) ancestry in the Prostate Cancer Risk Assessment Program, a prospective high-risk cohort. Eligibility criteria were age 35 to 69 years, family history of prostate cancer, African American race, or BRCA1/2 mutations. Biopsies were done at low PSA values (<4.0 ng/mL). WA ancestry was discerned by genotyping 100 ancestry informative markers. Cox proportional hazards models evaluated baseline PSA, self-reported race, and genetic WA ancestry. Cox models were used for 3-year predictions for prostate cancer. Six hundred forty-six men (63% African American) were analyzed. Individual WA ancestry estimates varied widely among self-reported African American men. Race-specific differences in baseline PSA were not found by self-reported race or genetic WA ancestry. Among men with > or =1 follow-up visit (405 total, 54% African American), 3-year prediction for prostate cancer with a PSA of 1.5 to 4.0 ng/mL was higher in African American men with age in the model (P = 0.025) compared with European American men. Hazard ratios of PSA for prostate cancer were also higher by self-reported race (1.59 for African American versus 1.32 for European American, P = 0.04). There was a trend for increasing prediction for prostate cancer with increasing genetic WA ancestry. "Race-specific" PSA may need to be redefined as higher prediction for prostate cancer at any given PSA in African American men. Large-scale studies are needed to confirm if genetic WA ancestry explains these findings to make progress in personalizing prostate cancer early detection.
Notes
Giri, Veda N Egleston, Brian Ruth, Karen Uzzo, Robert G Chen, David Y T Buyyounouski, Mark Raysor, Susan Hooker, Stanley Torres, Jada Benn Ramike, Teniel Mastalski, Kathleen Kim, Taylor Y Kittles, Rick CA06927/CA/NCI NIH HHS/United States Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S. United States Cancer prevention research (Philadelphia, Pa.) Cancer Prev Res (Phila Pa). 2009 Mar;2(3):244-50. Epub 2009 Feb 24.