MP60-17 DOES ATYPICAL SMALL ACINAR PROLIFERATION ON 1ST REPEAT BIOPSY INCREASE PROSTATE CANCER DETECTION?

RESULTS: In our cohort 50.2% of men identified as black. There were 523 positive biopsies. Controlling for covariates, whites were significantly less likely to have a positive biopsy (þBx) than either blacks (black v white OR1⁄489, 95% CI [22,364]) or others (other v white OR1⁄425, 95% CI [5.7,110). There was no statistically significant interaction between baseline PSA & race (p1⁄40.466). Baseline PSA was not a statistically significant independent predictor of Bx result (p1⁄40.101). There was however a statistically significant interaction between PSA change score & race (p1⁄40.031). OR for a 1-unit increase in PSA change score among whites was 1.20 (95% CI [1.07, 1.34]); the corresponding OR among blacks was 1.06 (95% CI [1.02, 1.10]); and among others was 1.03 (95% CI [0.99, 1.07]). CONCLUSIONS: In our majority-minority population, baseline PSA values were not statistically significantly associated with risk of future þBx. Change in PSA score from baseline to time of biopsy had very modest additional predictive utility among whites; less so among blacks. Thus our null hypothesis that a lower 1st PSA value at referral to Urology predicts a lower chance of being diagnosed with prostate cancer was not supported. This finding conflicts with the Malmo data. However, our data do support the higher risk of prostate biopsy positive for malignancy in black men with elevated PSA relative to white men with elevated PSA.