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Introduction:
Recent data suggest an underestimation of prostate cancer disease risk at diagnosis among AA men. We compared pre and post-treatment estimates of prostate cancer risk, to determine whether inaccurate assessment of disease risk at diagnosis differs by race.
Methods:
We identified Caucasian and AA men who underwent radical prostatectomy at our institution between 2012 and 2014. CAPRA and CAPRA-S scores were determined as estimates of pre- and post-operative disease risk. Differences between each patient’s CAPRA and CAPRA-S scores were calculated. Underestimation of disease risk at diagnosis was defined as a CAPRA score less than CAPRA-S score.
Results:
255 men met inclusion criteria, including 162 Caucasian (64%) and 93 AA (36%) men. CAPRA and CAPRA-S scores are shown in table 1, and did not differ significantly by race (CAPRA p=0.77, CAPRA-S p=0.29). Differences between each patient’s CAPRA and CAPRA-S score are shown in table 2. Risk underestimation occurred in 40% of AA men, compared to 25% of Caucasian men (p = 0.09). Multivariable logistic regression showed that AA race (p = 0.04) and younger age (p = 0.03) were associated with risk underestimation.
Conclusions:
Underestimation of prostate cancer risk at diagnosis is more common in AA, compared to Caucasian men. These findings suggest a need for improved risk assessment at diagnosis, and argue for more aggressive treatment of prostate cancer in AA men.