According to a new study published in The Journal of Urology, the introduction of prostate specific antigen (PSA) testing for screening and monitoring prostate cancer has improved survival rates for patients whose disease has metastasized to other areas of the body. In addition, PSA testing has resolved the disparity between African American and Caucasian men.
Lead researcher Ian M. Thompson, Jr., MD, Director of the Cancer Therapy and Research Center, a National Cancer Institute-Designated Cancer Center, and Professor in the Department of Urology at the UT Health Science Center at San Antonio, TX, explained:
“Our analysis indicates an overall improvement in risk adjusted survival rates for non-African American and African American men. Of note is the resolution of disparity in survival between the races found in earlier studies.”
Over the last 30 years, The Southwest Oncology Group have conducted clinical trials evaluating patient survival after androgen deprivation treatment (ADT) for prostate cancer. Of the three trials, two were conducted before the introduction of PSA screening.
Dr. Thompson said: “These sequential trials provide an opportunity to address the question of whether survival has improved since the advent of widespread PSA screening and follow-up testing.”
The first trial enrolled patients from 1985 to 1986. In this trial median survival was 30 months. In the second trial (1989-1994), median survival was 33 months, and in the third trial (1995-2009), median survival was 49 months.
In the trials researchers assessed various risk factors, including older age, race, body mass index, and extensive versus minimal disease. In the first study, median survival for African American men was 27 months, compared with 48 months in the third trial.
br> According to the researchers, African American men had poorer results in the earlier studies even though they received treatment in a carefully overseen clinical trial.
Dr. Thompson explained:
“When we evaluated ZIP code summary information regarding income and education, there was no shift in socioeconomic status over time. We hypothesize that this improvement is based on greater awareness of prostate cancer and improved health seeking behavior in African American men. However, African American men have a two- to three-fold greater incidence of newly diagnosed metastatic prostate cancer compared to white men, which contributes to a similarly increased mortality rate. A greater effort is needed to eliminate disparities in prostate cancer.”
He concludes: “While not all of these welcome improvements can be attributed strictly to PSA testing, without a doubt it has played a role in extending many lives.”
Written by Grace Rattue