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Positive adverse benefit data reported in black patients with prostate cancer

Data supporting prostate-specific antigen screening show that the trade-off between harm and benefit is more favorable with a complementary approach to quantifying overdiagnosis.

According to the results presented at the AUA 2022 Annual Meeting, the adverse benefit trade-off for prostate-specific antigen screening quantifies overdiagnosis compared to previous estimates using shorter follow-up from the introduction of screening. It turned out to be more advantageous with a complementary approach to.

These data strongly support prostate-specific antigen (PSA) screening, especially in black men who lack evidence of clinical trials, said Spyridon Basourakos, MD, a urologist at the Presbyterian Church in New York. data.

The epidemiology of prostate cancer in the United States is affected by prostate-specific antigen screening. Due to persistent racial differences in black male outcomes, retesting within this patient population is necessary to provide an understanding of the harm and benefits of screening compared to cancer-specific mortality.

During the study, experts estimated both overdiagnosis and overtreatment of all races, including black men aged 50-84 years until 2016, the latest year for which treatment data are available. Researchers have found potential harm and benefits for this population based on surveillance, epidemiology, and screening for prostate cancer in the United States based on surveillance, epidemiology, and final results (SEER) registries and US census data from 1986 to 2016. I checked. In addition, an established micro-simulation model of the natural history of prostate cancer was used.

By combining estimates with plausible mortality benefits, the number required for diagnosis (NND) and the number required for treatment (NNT) were calculated to prevent death from prostate cancer. Researchers have investigated how all races, especially black men, differ from prostate-specific mortality.

Patients of all races have been evaluated, and by 2016 it is estimated that 1.5-1.9 million (range between estimated approaches) will be overdiagnosed in the United States and 900-1.5 million will have over-treated prostate cancer. I did. From 1986 to 2016, researchers began PSA screening here, and two putative approaches created a similar age-standardized overdiagnosis burden.

Prostate cancer mortality first increased and then declined compared to 1986, reducing 270,000 deaths for men of all races and 55,000 for black men. Assuming that half of the 270,000 prostate cancer deaths avoided by 2016 are due to screening, NND and NNT are 11-14 and 7-11 for all races and 8- for black men. It will be 12 and 5-9.

Furthermore, when researchers explain the delay between incidence and mortality, the estimated NND and NNT for black men are well in the low single digits.

Overall, NND has significant benefits and has been shown to be NNT within black men compared to all races. There was a dramatic improvement in prostate cancer mortality in black men, but when this mortality rate is compared to individuals of all races, black men with prostate cancer have more than doubled the mortality rate. It turned out to be.

Still, there is a need to quantify the overdiagnosis, overtreatment, and trade-offs between harm and benefit in PSA treatment for black men. Basourakos et al. According to the report, more work needs to be done to understand why the mortality rate of black men is so high and dramatic.

reference:

Harm and Benefits of 30 Years of Prostate Cancer Screening in S Basourakos, R Gulati, R Vince and Other Black Men. Place of presentation: 2022 Annual Meeting of the American Urological Association. May 13-16, 2022; New Orleans, Louisiana. Abstract LBA01-01

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Positive adverse benefit data reported in black patients with prostate cancer

reference:

Harm and Benefits of 30 Years of Prostate Cancer Screening in S Basourakos, R Gulati, R Vince and Other Black Men. Place of presentation: 2022 Annual Meeting of the American Urological Association. May 13-16, 2022; New Orleans, Louisiana. Abstract LBA01-01