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Prostate cancer test works as well for black men, study shows

A new twist on the standard way to predict prostate cancer risk appears to offer African-American men a much-needed, improved accuracy in detecting the disease.

A review of data from a recent nationwide trial of the free prostate specific antigen test (fPSA) a variation on the traditional PSA test shows the new test proves as accurate in revealing cancer risk in African American men as it is in Caucasians.

"It also shows that many African-American men could be spared the expense and trauma of prostate biopsies," says Johns Hopkins urologist Alan W. Partin, M.D., Ph.D., co-leader of the research team. "Nearly 75 percent of the prostate biopsies that both black and white men get are unnecessary," says Partin.

A report on the study at Johns Hopkins and six other U.S. medical centers appears in the March issue of the journal Urology.

The fPSA, a more sensitive test for cancer risk than the standard PSA test men get as part of routine physicals, won Food and Drug Administration approval two years ago, based on a national trial of 773 men who had both tests as well as prostate biopsies. This earlier trial showed that fPSA detected 95 percent of the cancers.

It also reduced unnecessary prostate biopsies that men would have routinely after the standard PSA test.

A variety of races took part in this original trial, which compared the two tests as detectors of prostate cancer. "But because the trial was composed mostly of Caucasian men," Partin says, "we saw a need to re-analyze the data specifically for the subset of African-Americans, who are at far higher risk."

The new analysis shows no significant differences exist between blacks and whites in the performance of the fPSA test.

Since FDA approval, the fPSA is becoming a follow-up test for men whose PSA falls in a "diagnostic gray zone" of moderately elevated levels--4 /to 10 ng/ml. The risk of prostate cancer in this group is 25 per
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Contact: Marjorie Centofanti
mcentofanti@jhmi.edu
410-955-8725
Johns Hopkins Medical Institutions
4-Mar-2000


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