Department of Urology, Stellenbosch University and Tygerberg Hospital, Western Cape.
S Afr Med J. 2011 Apr;101(4):267-70. doi: 10.7196/samj.4420.
We aimed to compare the presenting features and management of prostate cancer among different racial groups.
We studied all patients diagnosed with prostate cancer at the Urological Oncology Clinic, Tygerberg Hospital, from January 1995 to December 2005. Most presented symptomatically as PSA screening is not readily available in the referral area of the hospital. Race was self-defined as white, coloured or black. Statistical analysis was performed using Student's t-test or Fisher's exact test, where appropriate. A two-tailed p-value <0.05 was accepted as statistically significant.
There were 901 patients: 291 (32.3%) white, 539 (59.8%) coloured and 71 (7.9%) black. Mean age at presentation was significantly higher in the white than the coloured and black groups (69.7, 67.9 and 68.9 years, respectively). Grade 1 adenocarcinoma was most common in the white (37%) and coloured groups (38%), and grade 2 was most common in the black group (39%). There was a significantly lower percentage of patients with T3-4 disease at diagnosis in the white group (47%) than the coloured (61%) and black (62%) groups. Mean serum PSA at diagnosis was significantly higher in the black than the coloured and white groups (766.1,673.3 and 196.1 ng/ml, respectively). Potentially curative therapy (radical prostatectomy or radiotherapy) was chosen by 31% of white, 23% of coloured and only 12% of black patients. The mean duration of follow-up was significantly shorter in the black than in the white or coloured groups (24.0, 31.5 and 35.0 months, respectively).
Black men presented with higher grade and stage disease and higher serum PSA, received potentially curative treatment less often, and had a shorter follow-up (probably owing to shorter survival) than the white and coloured groups. Greater prostate cancer awareness and education among patients and physicians and more widespread use of PSA screening of presymptomatic men at risk of prostate cancer is needed.
比较不同种族人群前列腺癌的临床表现和治疗方法。
我们研究了 1995 年 1 月至 2005 年 12 月在泰格伯格医院泌尿科肿瘤诊所就诊的所有前列腺癌患者。由于医院所在的转诊地区尚未普及 PSA 筛查，大多数患者都出现了症状。种族由患者自行定义，包括白人、有色人种或黑人。统计分析采用 Student's t 检验或 Fisher's 确切检验，适当情况下采用 Mann-Whitney U 检验。以双侧 p 值<0.05 为统计学显著。
共有 901 例患者：白人 291 例（32.3%），有色人种 539 例（59.8%），黑人 71 例（7.9%）。白人组患者的中位年龄显著高于有色人种组和黑人组（分别为 69.7、67.9 和 68.9 岁）。白人组和有色人种组中最常见的是腺癌 1 级（分别为 37%和 38%），而黑人组中最常见的是腺癌 2 级（39%）。白人组患者中诊断时 T3-4 期疾病的比例显著低于有色人种组（61%）和黑人组（62%）。黑人组患者的中位血清 PSA 水平显著高于有色人种组和白人组（分别为 766.1、673.3 和 196.1ng/ml）。白人、有色人种和黑人患者中分别有 31%、23%和 12%选择了根治性前列腺切除术或放疗。黑人组患者的中位随访时间显著短于白人组或有色人种组（分别为 24.0、31.5 和 35.0 个月）。
黑人患者的疾病分级和分期更高，血清 PSA 水平更高，接受根治性治疗的比例较低，随访时间较短（可能是因为生存期较短）。需要提高患者和医生对前列腺癌的认识和教育，并更广泛地对有前列腺癌风险的无症状男性进行 PSA 筛查。
