AUA 2017: Prostate Cancer Incidence Stratified By Race And Gleason Score: A Seer Database Analysis of The USPSTF Guideline Era

Boston, MA ( In 2008 and extended in 2012, the US Preventive Services Task Force (USPSTF) issued guidelines stating there was insufficient evidence to support prostate cancer screening. Dr. Au used the Surveillance Epidemiology and End Result (SEER) database to determine the effect of the recent USPSTF recommendations on prostate cancer incidence based on Gleason score (GS), and to identify differences in GS based on race.

The authors analyzed the SEER database from 2008-2013 and stratified patients on recorded race. GS were stratified as low (2-6), intermediate (7) or high (8-10). Incidence was compared between 2008 and 2013 by determining incidence rate ratio (IRR) and annual percentage change (APC). Changes in incidence rate by race and distribution of GS within racial groups since 2008 was analyzed as well.

Overall 337,504 patients diagnosed with prostate cancer were found within SEER between 2008 and 2013. The mean age range was between 65-74 years. Majority (68.1%) of patients were White, followed by 14.6% Black. GS 2-6 was recorded for 41.8%, followed by GS 7 in 36.2% of patients, and GS 8-10 in 15.9% of patients. Cumulative six year GS 2-6 incidence was noted to be 76.2, 52.9, 44.7 and 25.0 per 100,000 for Black (B), White (W), Hispanic (H), and Asian/Pacific Islanders (API), respectively. GS 7 incidences were 81.3, 46.4, 36.2 and 23.4 per 100,000 for B, W, H, and API, respectively. GS 8-10 was reported in 37.5, 21.0, 21.7 and 18.0 per 100,000 for B, W, H, and API, respectively. GS <=6 had an overall decline of 39% with a 36-40% racial variance. GS 7 had an overall 35% decline with a 26-40% racial variance. Lastly, GS 8-10 had an overall decline of 13% with an 11-22% racial variance.

Major limitations included no control for sociodemographic factors, and lack of sub-analysis by age or stage group. In summary, analysis of SEER data demonstrates a decline in incidence of prostate cancer among all races in this time period.

Presented By: Daniel Au, Saint Louis, MO

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA