Prostate cancer screening in high-risk men

African American Hereditary Prostate Cancer Study Network

Authors

  • Sally P. Weinrich Ph.D.,

    Corresponding author
    1. School of Nursing, Medical College of Georgia, Augusta, Georgia
    • School of Nursing, Medical College of Georgia, Augusta, GA, 30912
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    • Fax: (706) 721-0655

  • African American Hereditary Prostate Cancer Study Network

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    • Dr. S. Weinrich is Professor, School of Nursing, Medical College of Georgia, Augusta, Georgia. Dr. M. Weinrich is Professor, School of Nursing, Medical College of Georgia, Augusta, Georgia. Dr. Curtis Pettaway is Associate Professor and Urologist, Department of Urology, M.D. Anderson Cancer Center, Houston, Texas. Dr. Srinivasan Vijayakumar is Professor and Oncologist, Radiation and Cellular Oncology, Michael Reese Hospital & Medical Center, Chicago, Illinois. Dr. Isaac J. Powell is Urologist, Department of Urology, Wayne State University, Detroit, Michigan. Dr. James K. Bennett is Urologist, Midtown Urology; Clinical Associate Professor, Emory University School of Medicine; Adjunct Clinical Assistant Professor, Morehouse School of Medicine, Atlanta, Georgia. Dr. Chiledum A. Ahaghotu is Assistant Professor, Department of Surgery Urology Division, Howard University, Washington, D.C. Dr. Gerald Hoke is Urologist and Assistant Professor of Clinical Urology, Columbia Presbyterian Medical Center, New York, New York. Dr. Terry Mason is Urologist and Assistant Professor of Surgery, University of Illinois, Chicago, Illinois. Dr. William H. Boykin is Urologist, Urology Center of Northeastern Kentucky, Ashland, Kentucky. Julie Priest is Programmer, University of South Carolina, Columbia, South Carolina. Pam Roberson-Smith is Nurse, M.D. Anderson Cancer Center, Houston, Texas. Jacqueline Frost is Nurse, M.D. Anderson Cancer Center, Houston, Texas. Carol Meegan is Nurse, Michael Reese Hospital, Chicago, Illinois. Edna Johnson is Nurse, Karmanos Cancer Institute, Detroit, Michigan. Louise Faison-Smith is Interviewer, University of South Carolina, Columbia, South Carolina. Cathy Atkinson is Project Manager, University of South Carolina, Columbia, South Carolina. Tia Robertson is Clinical Research Manager, Midtown Urology, Atlanta, Georgia. Shannon Smith is Project Coordinator, AAHPC, Howard University, Washington, D.C. Dr. Raul Mejia is Physician, Harlem Hospital Center, New York, New York. Dr. Charmaine Royal is Principal Investigator of the GenEthics Core and Assistant Professor, Department of Pediatrics and Child Health, Division of Medical Genetics, National Human Genome Center, Howard University, Washington, D.C. Ernest Mensah, is Programmer, Howard University, Washington, D.C. Dr. Rick Kittles is Associate Professor Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus, Ohio. Dr. Jeffrey Trent is Geneticist, National Human Genome Research Institute, Bethesda, Maryland. Dr. John Carpten is Senior Investigator and Director, Genetic Basis of Human Disease Division, Translational Genomics Research Institute, Phoenix, Arizona. Dr. Kate Berg is Director, Special Populations Research Program, National Human Genome Research Institute, Bethesda, Maryland. Dr. Joan Bailey-Wilson is Senior Investigator, Inherited Disease Research Branch, National Human Genome Research Institute, Bethesda, Maryland. Dr. Agnes Baffoe-Bonnie is Genetic Epidemiologist, Fox Chase Cancer Center, Philadelphia, Pennsylvania. Dr. Francis Collins is Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland. Dr. Georgia Dunston is Professor, Department of Microbiology, College of Medicine, Howard University, Washington, D.C.


Abstract

BACKGROUND

There are scant data available on prostate cancer screening among high-risk African American men with positive family histories. It is important to determine whether or not their screening rates differ from those in the general population.

METHODS

This study computed rates of previous digital rectal examination (DRE) and prostate-specific antigen (PSA) screening for prostate cancer in cancer-free (unaffected) relatives age 40–69 years from African American families that had four or more men with prostate cancer. The rates for these 134 high-risk African American men from the African American Hereditary Prostate Cancer Study (AAHPC) were compared with nationwide estimates obtained from participants in the 1998 and 2000 National Health Interview Survey (NHIS), for which the numbers of demographically comparable subjects were 5583 (4900 Caucasians, plus 683 African Americans) and 3359 (2948 Caucasians, 411 African Americans), respectively.

RESULTS

Men in the AAHPC cohort (with a strong positive family history) had significantly less screening than both African Americans and Caucasians in the NHIS cohorts. Only about one-third (35%) of the men in the AAHPC unaffected cohort had ever had a DRE, and only about 45% of them had ever received a PSA test. These rates were much lower than those obtained for African American men in the NHIS: 45% for DRE and 65% for PSA. These discrepancies increased with age.

CONCLUSIONS

Older African American men with positive family histories report surprisingly low rates of DRE and PSA screening compared with their counterparts in the NHIS surveys. At-risk men need to be informed of the benefits and limitations of prostate cancer screening and actively involved in decision-making for or against prostate cancer screening. Cancer 2006. © 2006 American Cancer Society.

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