Introduction

Introduction and Objective_x000D_ African American (AA) men tend to present with higher risk prostate cancer (CaP) with poorer prognosis than a non-AA cohort. It has been postulated that the burden of anterior prostate lesions (APL) may be greater and more aggressive in AA men leading to CaP evasion of detection and increased mortality. We aim to compare the rates and grade of APLs in AA and non-AA males. _x000D_

Methods

A retrospective database was established including 463 men (64 AA, 399 non-AA) at an academic hospital who underwent prostate biopsy following MRI from to June 2014 to September 2016. These patients did not carry a diagnosis of CaP. Multiparametric magnetic resonance imaging (mpMRI) was used to identify lesions suspicious for CaP. A 3-Tesla MRI machine and Invivo software was utilized for fusion.

Results

The AA male population studied showed no significant difference in age (p=0.92), or gland volume (p=0.73). However, median prostate specific antigen (PSA) (7.9 vs. 6.3; p<0.001) and PSA density (PSAD) (.134 vs.111; p<0.03) were significantly higher in the AA population. Despite this, there were fewer AA men with anterior lesions (15/64, 23.4%) then non-AA men (112/399, 28.1%). Additionally, there was no significant difference in maximum lesion size from the AA group to the control. When these lesions were biopsied, the ratios of both APLs and total lesions shown to be Gleason 7 or higher were equivalent for both populations.

Conclusions

AA men were slightly less likely to have an anterior lesion mpMRI, but had equivalent total lesions and maximal lesion dimensions. Despite higher PSAD, AA men were equally likely to have clinically significant APLs and CaP in general. These findings contradict conventional hypotheses in urology and may implicate a more complex multifactorial cause for the prognostic disparity observed.

Funding

none