Leung AK, et al. - Experts identified the men presenting to a tertiary care safety-net hospital with prostate-specific antigen (PSA) values ≥100 ng/mL and assessed a potential population for targeted PSA screening. At a safety-net hospital, men presenting with PSA≥100ng/ml, the majority were African-American (AA), of lower socioeconomic status, and had metastatic disease. As per data, uniform absence of PCa screening could be exposed by the greater numbers of at-risk men to similar outcomes.

Methods

• Researchers conducted a retrospective review of 100 randomly selected patients out of 204 total who presented to Grady Memorial Hospital from 2004-2011 with initial PSA≥100 ng/mL.
• They obtained the demographics, disease characteristics, and survival status via the Tumor Registry and a combination of electronic medical records and older paper charts, with missing data from paper charts excluded on analyses.

Results

• Results demonstrated that 65 patients were newly diagnosed with PCa on presentation and 35 were previously diagnosed.
• Authors noted that median PSA at presentation was 405.5 ng/mL (min 100, max 7805), 81% had metastatic disease, and 94% were Gleason≥7.
• They found that median CAPRA score was 8.
• At presentation, median age was 67.4 years (min 40.8, max 90.6).
• Findings suggested that 89% of patients were African-American (AA), 24% lived alone, 12% were homeless or incarcerated, 51% were insured by Medicare/Medicaid, and 47% were uninsured.
• HIV was seen only 1%, 19% had diabetes, and 13% had chronic kidney disease.
• Only 23% had ever been screened and 9% previously biopsied out of the 65 newly diagnosed patients.
• From presentation to death median time was seen to be 17.8 months (min 0.16, max 107.1).