Prostate-specific Antigen as a Risk Factor for Skeletal Metastasis in Native Ethnic African Men with Prostate Cancer: A Case-control Study

نویسندگان

  • Ayman M. Qureshi
  • Khalid Makhdomi
  • William Stones
چکیده

Prostate cancer is the most common noncutaneous cancer in males. Men of African origin are at a significantly higher risk as reflected in the higher incidence and mortality rates in this racial group. Metastases incidence increases parallel to serum levels of prostate-specific antigen (PSA), contributing significantly to morbidity and mortality. Staging of the disease involves bone scans, which are sensitive in detecting skeletal metastases. Suggestions that these scans may be omitted in some situations in patients with low prostate specific antigen levels have drawn attention to the matter. In this case-control study, using radiology and pathology records, a registry of prostate cancer patients recorded as being of dark-skinned ethnicity was obtained. Images were presented to image reviewers blinded to the PSA level, to determine the presence of skeletal metastases. The risk factor for the outcome of interest (skeletal metastases) was PSA level above 20 ng/mL. The reliability of image reporting was also assessed. Of the 122 patients, skeletal metastases were present in 50 (41%) while these were absent in 72 (59%). The prevalence of metastases among the high PSA group was 55.9% [95% confidence interval (CI) 44.1-67.7%] and among the normal/low PSA group was 22.2% (95% CI 11.1-33.3%). The odds ratio (OR) for skeletal metastases in the exposed (high PSA) group was 4.4 (95% CI, 2.01-9.78.) Intraobserver agreement on image interpretation was 88.5% with a Kappa statistic of 0.76. A relatively higher prevalence of skeletal metastasis is seen in regional dark-skinned African males with prostate cancer at both low and high prostate specific antigen levels. Bone scanning in this population should therefore, be considered even at PSA levels below 20 ng/mL.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Prostate Cancer Screening in Middle-Aged and Older American Men: Combined Effects of Ethnicity and Years of Schooling

Background: Prostate cancer screening is more commonly utilized by highly educated people. As shown by marginalization-related diminished returns (MDRs), the effects of socioeconomic status (SES) such as education on the health outcomes are considerably smaller for ethnic minorities than for Whites. The role of MDRs as a source of ethnic health disparities is, however, still un...

متن کامل

Association between rs2735839 and Serum Prostate-specific Antigen Level Regarding Risk of Prostate Cancer in Iranian Population

Background and Objective: Prostate cancer is among the five common cancers in males. It is second cancer in terms of the age-standardized rate (ASR) (ASR=16.6) in Iran. The rs2735839 G/A, an intergenic polymorphism is located on chromosome 19q13.33 at 600 base pairs of the KLK3 gene untranslatable region. This gene which codes prostate-specific antigen (PSA) is used in the screening and diagnos...

متن کامل

Investigation of the relationship between prostate specific antigen doubling time and the severity of a malignant tumor of the prostate

Background: Prostate cancer has been reported as a worldwide important kind of cancer and the second most common cause of cancer-related mortality among men. Prostate-specific antigen (PSA) serum level is one of the most important markers of prostate cancer diagnosis. While PSA level helps predict the risk of prostate cancer development, researchers still looking for ways to increase the accura...

متن کامل

Age Specific Reference Levels of Serum Prostate-Specific Antigen, Prostate Volume and Prostate Specific Antigen Density in Healthy Iranian Men

Background: It is relevant to highlight that there is not a precise and perfect report on either 95 percentile value (upper limit of normal range) or on appropriate reference intervals for serum PSA in Iranian population. Objective: To determine age-specific reference ranges for serum prostate-specific antigen (PSA) concentration and PSA density (PSAD) and prostate volumes in a population of he...

متن کامل

PSA Screening in Prostate Cancer

Introduction: Prostate cancer is one of the most common cancers in Iranian men. PSA(prostate specific antigen) screening is a controversial issue because PSA screening leads to diagnose of patients with low risk prostate cancer who not only do not benefit from treatment but also suffer from complication caused by treatment. On the other hand, without prostate cancer screening, the rate of meta...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 16  شماره 

صفحات  -

تاریخ انتشار 2017