A single baseline PSA measurement taken during midlife strongly predicted the subsequent diagnosis of aggressive prostate cancer up to 12 years later among African-American men in the United States, according to researchers.
Findings of the case-control study corroborate results of two earlier studies in the United States and Sweden suggesting midlife PSA had predictive value for prostate cancer in largely Caucasian populations.
The findings also help fill a research gap by providing new data on the potential role of midlife PSA measurement in African-American men, who suffer a higher burden of disease versus Caucasian men, said authors of the study published in European Urology (Sept. 17, 2018 [Epub ahead of print]).
Taken together, the findings of the three studies to date provide “strong support” for using a midlife PSA level to determine a personalized screening strategy, according to lead author Mark A. Preston, MD, MPH, of Harvard Medical School, Boston, and his co-authors.
“There's a solid body of evidence now that a midlife PSA is very predictive of aggressive prostate cancer, and risk-stratified screening, or smarter screening, is where we should be headed,” Dr. Preston said in an interview with Urology Times.
This latest study provides “promising” evidence that midlife PSA measurement could indeed improve on standard PSA screening, though more research is needed, according to authors of an editorial commenting on the results (Eur Urol Sept. 26, 2018 [Epub ahead of print]).
“The extent to which any personalized screening program would reduce overdiagnosis and overtreatment remains unclear,” authors Rebecca E. Graff, PhD, Linda Kachuri, PhD, and John S. Witte, PhD, of the University of California, San Francisco, wrote in their editorial.
That said, the present study highlights the association between midlife PSA levels and aggressive disease, since aggressive disease is the most clinically relevant and less likely to be over-diagnosed, Dr. Preston and colleagues said in their report.