Studies have suggested that African American men with low-risk prostate cancer may experience more aggressive disease and progression and than Non-Hispanic men. Hence, whether active surveillance is a safe option for them or not is not clear. This study aims to compare the clinical outcomes of low-risk prostate cancer managed by active surveillance in African American and Non-Hispanic men.
This retrospective cohort study included a total of 8,276 men, 2,280 African Americans, and 6,446 non-Hispanic Whites. The exposures included active surveillance defined as no definite treatment within the first year of disease diagnosis. The primary outcome of the study was progression to at least intermediate-risk, definitive treatment, prostate cancer-specific mortality, metastasis, and all-cause mortality.
During a median follow-up of 7.6 years, the 10-year cumulative incidence of disease progression was 59.9% in African American men and 48.3% in non-Hispanic White men. Similarly, the receipt of disease progression was 54.8% vs. 41.4%, metastasis was 1.5% vs. 1.4%, prostate-specific cancer mortality was 1.1% vs. 1.0%, and all-cause mortality was 22.4% vs. 23.5%.
The research concluded that African American men with low-risk prostate cancer had an increased 10-year cumulative incidence of disease progression but not mortality when compared with non-Hispanic Whites.