Prostate Cancer Mortality in Men Aged 70 Years Who Recently Underwent Prostate-Specific Antigen Screening

JAMA Network Open, Год журнала: 2025, Номер 8(2), С. e2459766 - e2459766

Опубликована: Фев. 14, 2025

Importance Continuing prostate-specific antigen (PSA) screening after age 70 years might benefit men at high risk of prostate cancer–specific mortality (PCSM) or metastatic cancer (mPCa), but the relative value clinical factors (race and ethnicity, competing mortality, PSA history) in identifying higher vs lower is unknown. Objective To examine levels, race stratification for PCSM mPCa years. Design, Setting, Participants In this cohort study, data all receiving health care through Veterans Health Administration who turned between 2008 2020 had a normal 65 69 (<4 ng/mL [baseline PSA]) no prior history biopsy were examined. The cutoff date was December 26, 2023. Exposure most recent from to years, self-reported derived machine learning model. Main Outcome Measures 10-year absolute determined using regression modeling. Results included 921 609 2020; 11% whom as Black 82% White race. Between 45% patients baseline less than 1.00 ng/mL, 32% 1.99 ng/mL. Most (87%) continued undergo past with little variation by ethnicity. cumulative incidence 0.26% overall, 95% 0.73%. Higher level associated (0.79% 3.00-3.99 0.10% 0.20-0.99 ng/mL), ethnicity (0.36% 0.25% White), (0.24% highest quintile 0.21% lowest quintile). Similar results found mPCa. Low (0.20-0.99 ng/mL) very low risk, even among healthiest (10-year 0.08% [95% CI, 0.01%-0.44%]; 0.24% 0.10%-0.52%]). Conclusions Relevance findings suggest that VHA continue despite risks. values may be highly informative adverse outcomes 1 long-term

Язык: Английский

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Prostate Cancer

JAMA, Год журнала: 2025, Номер unknown

Опубликована: Март 10, 2025

Importance Prostate cancer is the most common nonskin in men US, with an estimated 299 010 new cases and 35 250 deaths 2024. second worldwide, 1 466 680 396 792 2022. Observations The type of prostate adenocarcinoma (≥99%), median age at diagnosis 67 years. More than 50% risk attributable to genetic factors; older Black race (annual incidence rate, 173.0 per 100 000 vs 97.1 White men) are also strong factors. Recent guidelines encourage shared decision-making for prostate-specific antigen (PSA) screening. At diagnosis, approximately 75% patients have localized prostate, which associated a 5-year survival rate nearly 100%. Based on stratification that incorporates life expectancy, tumor grade (Gleason score), size, PSA level, one-third appropriate active surveillance serial measurements, biopsies, or magnetic resonance imaging, initiation treatment if Gleason score stage increases. For higher-risk disease, radiation therapy radical prostatectomy reasonable options; should include consideration adverse events comorbidities. Despite definitive therapy, 2% 56% disease develop distant metastases, depending presentation, 14% metastases regional lymph nodes. An additional 10% 37%. Treatment metastatic primarily relies androgen deprivation commonly through medical castration gonadotropin-releasing hormone agonists. newly diagnosed cancer, addition receptor pathway inhibitors (eg, darolutamide, abiraterone) improves survival. Use abiraterone improved overall from 36.5 months 53.3 (hazard ratio, 0.66 [95% CI, 0.56-0.78]) compared alone. Chemotherapy (docetaxel) may be considered, especially more extensive disease. Conclusions Relevance Approximately 1.5 million annually worldwide. present Management includes surveillance, prostatectomy, progression. has First-line therapies novel inhibitors, chemotherapy patients.

Язык: Английский

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Evaluating Cancer Screening in the Era of Advanced Causal Inference Methods: Innovation, Adherence, and Health Equity Considerations

JCO Clinical Cancer Informatics, Год журнала: 2025, Номер 9

Опубликована: Янв. 1, 2025

Язык: Английский

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A multi-perspective study assessing Black and African American participation barriers in prostate cancer clinical trials

Future Oncology, Год журнала: 2025, Номер unknown, С. 1 - 7

Опубликована: Фев. 24, 2025

Aims This study aimed to partner with patients, advocates, and physicians better understand the barriers that exist for Black African Americans enroll in prostate cancer (PCa) clinical trials.

Язык: Английский

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Contemporary neighborhood redlining and racial mortgage lending bias and disparities in prostate cancer survival

Cancer, Год журнала: 2025, Номер 131(8)

Опубликована: Апрель 15, 2025

Abstract Background Mortgage lending bias is a critical driver of residential segregation, and may contribute to disparities in cancer survival. This study investigated the association between contemporary redlining racial prostate Methods cohort used Surveillance, Epidemiology, End Results–Medicare database that included 34,163 Black White men diagnosed with 2010 2013. Home Disclosure Act data were calculate census‐tract index (the systematic denial mortgages based on property location) mortgage application for applicant compared local area). Both indices assessed continuously categorically (low, moderate, or high). Multivariable‐adjusted Cox models estimate hazard ratios (HRs) cancer–specific all‐cause mortality. Results Overall, as increased, experienced poorer Compared residing low‐redlined neighborhoods, those high‐redlined neighborhoods had an increased risk mortality (HR, 1.21; 95% confidence interval [CI], 1.03–1.42) 1.25; CI, 1.17–1.34). Similar results observed race‐stratified analysis among men. Among men, low high 1.11; 1.03–1.21). Conclusions Contemporary was associated survival overall population. However, elevated only Findings suggest discrimination

Язык: Английский

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Prostate Cancer Foundation White Paper on Combination Therapy for Metastatic Hormone-Sensitive Prostate Cancer

JCO Oncology Practice, Год журнала: 2025, Номер unknown

Опубликована: Май 2, 2025

Despite several randomized controlled trials demonstrating the benefits of combination therapies for metastatic hormone-sensitive prostate cancer (mHSPC), a significant treatment gap persists. This initiative by Prostate Cancer Foundation (PCF) convened stakeholders from academia, community practices, industry, and patient advocacy groups to address critical challenges in mHSPC care. Expert discussions review real-world evidence meta-analyses informed development strategies improve care delivery. Evaluation data global registries, such as IRONMAN, large databases was used assess utilization patterns disparities. Combination with two agents—androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI)—or three agents—ADT + ARPI docetaxel—demonstrate survival improvements while preserving quality life patients mHSPC, yet adoption remains inconsistent. Of eligible patients, 20%-60% remain undertreated, geographic, financial, systemic barriers contributing inconsistencies Younger, White, urban-dwelling fewer comorbidities are more likely receive treatment, highlighting disparities across populations. Meta-analyses identified lack standardization due varying inclusion criteria comparators trials. Real-world underscored influenced geographic location, practice type, access specialty Initiatives PANTHER study highlight improved outcomes Black treated therapies, emphasizing importance including diverse populations clinical To bridge gaps care, this prioritizes awareness, standardization, equitable evidence-based therapies. Proposed solutions include targeted knowledge dissemination strategies, educational resources, policy changes promote guideline-concordant By leveraging collaborative efforts, organizations, PCF, can contribute enhancing all mHSPC.

Язык: Английский

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Optimising the use of the prostate- specific antigen blood test in asymptomatic men for early prostate cancer detection in primary care: report from a UK clinical consensus

British Journal of General Practice, Год журнала: 2024, Номер 74(745), С. e534 - e543

Опубликована: Июль 22, 2024

Screening is not recommended for prostate cancer in the UK. Asymptomatic men aged ≥50 years can request a prostate-specific antigen (PSA) test following counselling on potential harms and benefits. There are areas of clinical uncertainty among GPs, resulting content quality varying.

Язык: Английский

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Racial disparities in prostate cancer in the UK and the USA: similarities, differences and steps forwards

Nature Reviews Urology, Год журнала: 2024, Номер unknown

Опубликована: Окт. 18, 2024

Язык: Английский

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Racial disparity in prostate cancer: an outlook in genetic and molecular landscape

Cancer and Metastasis Reviews, Год журнала: 2024, Номер 43(4), С. 1233 - 1255

Опубликована: Июнь 20, 2024

Язык: Английский

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How Can Guidelines Give Clearer Guidance on Prostate Cancer Screening?

JAMA Oncology, Год журнала: 2024, Номер unknown

Опубликована: Сен. 26, 2024

This Viewpoint explores how guideline groups can come together to agree on a framework that produces clear and unified recommendations.

Язык: Английский

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