Prostate cancer diagnosed earlier, race gap narrows

NEW YORK (Reuters Health) - Men with prostate cancer are being diagnosed at a younger age and earlier stage today than in years past, and the racial disparity in stage at diagnosis has decreased significantly, researchers report today in the Journal of the National Cancer Institute.

"Traditionally, blacks are diagnosed with prostate cancer at a later stage compared with whites," and are more likely to die of the disease, study co-author Dr. Grace L. Lu-Yao of the University of Medicine and Dentistry of New Jersey in New Brunswick, told Reuters Health.

Lu-Yao and colleagues analyzed 2004-2005 data from the Surveillance, Epidemiology, and End Results Program on more than 82,500 prostate cancer patients.

They compared this group with patients diagnosed in 1988-1989 and 1996-1997.

The average age at diagnosis decreased from about 72 years in 1988-1989 to about 67 years in 2004-2005 and the rate of particularly late-stage cases fell from about 53 to 8 per 100,000 among whites and from 91 to 13 per 100,000 among blacks.

Based on the 2004-2005 data, the vast majority of men had cases diagnosed when they had not yet spread, Lu-Yao said.

Lu-Yao credited prostate-specific antigen (PSA) screening for the earlier diagnoses. While that test is recommended by some medical groups, the U.S. Preventive Services Task Force "concludes that the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years" and that men over the age of 75 should not be screened.

The questions over screening come from the fact that many prostate cancers are slow-growing and may not be deadly, while the treatments can have significant side effects.

The current study also "is the first nationwide study to document that the racial disparity in prostate cancer stage at diagnosis has decreased substantially during the period from 1988 to 2005," Lu-Yao noted.

"Whether the narrowing of the racial disparity in the presentation of advanced prostate cancer will lead to reduced racial disparity in prostate cancer mortality remains to be seen," Lu-Yao said.

SOURCE: Journal of the National Cancer Institute, August 27, 2009.