The epidemiology of prostate cancer (Ca-P) has never been investigated in Haitian men living in the United States. To our knowledge, no epidemiologic studies are available related to prostate cancer in Haitian men living in Haiti. This study represents the first epidemiological investigation in a large cohort of Haitian men at risk for prostate cancer. We demonstrate results of transrectal ultrasound (TRUS) prostate needle biopsies in a cohort of 1430 men.
METHODS:
Between April 2012 and September 2019, 1430 men of Haitian origin underwent transrectal ultrasound (TRUS) guided prostate biopsy using a DP50 7.5 MHZ endorectal probe. Serum PSA was obtained from peripheral blood in a standard laboratory in the United States. Indications for biopsy included: (1) PSA elevation >4.0 ng/ml; (2) Rising PSA within the normal range of 0.0-4.0 ng/
ml; (3) abnormal prostate digital rectal examination (DRE) . Data points collected included age, DRE, PSA, TRUS prostate volumes, and biopsy pathology diagnosis. Special notation was made in cases of high risk Ca-P by Gleason score, which was correlated with PSA and % Ca-P within total length of all core specimens retrieved.
RESULTS:
The mean patient age for the TRUS prostate needle biopsy was approximately 66 years (n=1430). The pathology findings revealed that 34% of the subjects had prostate cancer, 57% had benign hyperplasia, 5.6% had high grade intraepithelial neoplasia, and 3.5% had atypia. Prostate cancer was diagnosed in 33.9% of men who underwent prostate biopsy- only 56.9% had a completely benign prostate biopsy. The results display that 48.6% of the subjects had a Gleason of 6, 41% of the subjects had a Gleason of 7, and 10.3% had a Gleason greater than 8. Overall, there was a positive correlation between Gleason score and clinical stages. In our cohort, Haitian men were more likely to choose radiation treatment (63%) rather than radical prostatectomy (24%) or cryotherapy (13%) when presenting with clinically localized disease.
CONCLUSION:
This is the first epidemiological investigation in a large cohort of Haitian men at risk for prostate cancer. This report displays the results of TRUS prostate needle biopsy in Haitian men as a pure population. While mean age at diagnosis of Ca-P was similar to what has been previously reported in larger non-Haitian studies; men of Haitian origin present with higher PSA value and Gleason score than the general population. Further studies are needed in order to better understand the epidemiology and biology of prostate cancer in Haitian men.
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Angelo E. Gousse, MD
Clinical Professor of Urology – Herbert Wertheim College of Medicine – FIU
Voluntary Professor of Urology – University of Miami , Miller School of Medicine
Director of Fellowship:Female Urology,Voiding Dysfunction, Reconstruction
Memorial Hospital Miramar, South Broward Hospital District
1951 SW 172 Avenue, Suite 305,
Miramar, FL, 33029
Tel: 954-362-2720 Fax: 954-362-2761
www.bladder-health.net