A Prospective Study Of The Serum Prostate Specific Antigen Concentrations And Gleason Histologic Scores Of Black And White Men With Prostate Carcinoma

Jackson E. Fowler, Jr., Steven A. Bigler
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001

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Reviewers: Li Liu, MD
Source: Cancer, 86(5):836-841, September 1999


Successful stratification of patients for any risk variable would enhance our understanding of the disease and therefore enable us to develop effective strategies for managing subsets of patients. This is especially true for prostate cancer since African American men have the highest incidence of prostate carcinoma in the world. Drs. Fowler and Bigler reported this interesting study to confirm and expand our knowledge of racial differences in prostate carcinoma.


Fowler and Bigler prospectively studied 796 consecutive men (465 black and 331 white) with prostate cancer at the VA Hospital associated with the University of Mississippi.


  • High mean serum PSA concentrations and Gleason score 8-10 tumors were much more common among blacks with prostate cancer than whites regardless of the volume of the prostate or age of the patient.
  • For patients 65 years or younger, the mean PSA values of black and white men with localized cancer were 11.6 and 6.9, respectively (p=0.0009).


It has been hypothesized that black Americans have higher circulating levels of testosterone than whites. This may be one explanation for racial differences in the risk of developing prostate cancer. The implication is that black American men should be tested for prostate carcinoma at an earlier age than white men. More studies are needed to explore the underlying genetic differences, which are linked, to the risk of prostate carcinoma.


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