Prostate cancer among different racial groups in the Western Cape : presenting features and management
Date
2011-04
Authors
Heyns, C. F.
Fisher, M.
Lecuona, A.
Van der Merwe, A.
Journal Title
Journal ISSN
Volume Title
Publisher
Health and Medical Publishing Group (HMPG)
Abstract
Objectives. We aimed to compare the presenting features and
management of prostate cancer among different racial groups.
Patients and methods. 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.
Results. 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).
Conclusions. 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.
Description
The original publication is available at http://www.samj.org.za
Keywords
Prostrate -- Cancer -- South Africa -- Western Cape
Citation
Heyns, C. F., Fisher, M., Lecuona, A. & Van Der Merwe, A. 2011. Prostate cancer among different racial groups in the Western Cape: Presenting features and management. South African Medical Journal, 10(4):267-2770.