RACIAL DIFFERENCES IN PROSTATE CANCER PREVALENCE

Objective: To evaluate racial differences in prostate cancer prevalence in Brazil. Materials and Methods: We evaluated 1,773 men submitted to digital rectal examination (DRE), serum total prostate-specific antigen (PSA) assay, and the AUA-IPSS questionnaire from 1992 to 1997. They were classified according to the race in whites (1180 men), blacks (201 men) and yellows (45 men). Racial classification was not possible in 347 men. When PSA and/or DRE were abnormal, transrectal ultrasound guided prostate biopsy was indicated. Clinical stage and Gleason score were recorded and racial prevalence were compared. Results: 346 biopsies were performed and 51 cancers were diagnosed (positive biopsy rate of 14.7%). The distribution of PSA among these cancer cases was normal PSA in 4 (7.8%), between 4 ng/ml and 10 ng/ml in 16 (31.4%), and PSA > 10 ng/ml in 31 (60.8%). The cancer prevalence in white men was 2.4% and in black men 5.5% (p 0.05). Median PSA was 3 ng/ml for white men and 3.3 ng/ml for black men (p > 0.05). Black men had higher prevalence of abnormal DRE (18.9% versus 11.7%, p < 0.05). Median education class for white men was 3 and for black men 2 (p < 0.05). Prevalence of clinically localized cancer was 61.3%. Conclusions: The prevalence of prostate cancer is higher in blacks than in whites (5.5% versus 2.4%). The median PSA was similar for both racial groups. DRE abnormalities in black men were more prevalent than in white men (18.9% versus 11.7%).