Racial and Ethnic Variation in Time to Prostate Biopsy after an Elevated Screening Level of Serum PSA.

To examine the racial and ethnic variation in time to prostate biopsy after an elevated screening level of serum prostate-specific antigen (PSA).

Male members of the Kaiser Permanente of Southern California health plan, 45 years of age or older, with no history of prostate cancer or a prostate biopsy and at least one elevated screening level of serum PSA between January 1(st), 1998 and December 31(st), 2007 were retrospectively identified (n=59,506). All participants were passively followed via electronic health records until their time of prostate biopsy, death, membership disenrollment or study conclusion (December 31(st), 2014), whichever was the initial event. Proportional hazard regression analyses were used to estimate the association between time from an elevated screening level of serum PSA to prostate biopsy, adjusting for age, benign prostatic hyperplasia, prostatitis, type 2 diabetes mellitus, hypertension and Charlson comorbidity index score.

Median time until biopsy was 0.6 years (214 days) with approximately 41% of participants receiving a prostate biopsy within the study period. Results from the fully-adjusted analysis indicated that the non-Hispanic Asian or Pacific Islanders (HR: 1.10, 95% CI: [1.04, 1.15]) and the non-Hispanic blacks (HR: 1.04, 95% CI: [1.00, 1.08]) had a slightly shorter time to prostate biopsy after an elevated screening level of serum PSA compared to the non-Hispanic whites.

These data suggest, within an integrated health care organization, minimal differences exist between racial and ethnic sub-groups in their time to prostate biopsy after an elevated screening level of serum PSA.

Urology. 2016 Jun 14 [Epub ahead of print]

Stephanie R Reading, Kimberly R Porter, Jin-Wen Y Hsu, Lauren P Wallner, Ronald K Loo, Steven J Jacobsen

Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA., Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA., Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA., Department of Medicine and Epidemiology, University of Michigan, Ann Arbor, MI., Department of Urology, Kaiser Permanente of Southern California, Los Angeles, CA., Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA. Electronic address: .