Treatment of Prostate Cancer: Risk Assessment in Black Men with Dr. Adam Murphy

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Prostate cancer risk in Black men remains disproportionately high, with both incidence and mortality rates exceeding those in other populations. In this presentation, Adam B. Murphy, MD, MBA, MSCI, from Northwestern University Feinberg School of Medicine, Chicago, Illinois, explains why recalibrating screening strategies is essential to address these disparities.

Dr. Murphy details how the Prostate Cancer Foundation now recommends lowering the age for baseline prostate-specific antigen (PSA) screening for Black men to 40 to 45 years, reflecting their elevated risk. He explains how a higher prevalence alters the performance of current screening tools, increasing the positive predictive value while lowering the negative predictive value, which can lead to missed diagnoses.

He evaluates biomarker platforms, such as the Stockholm-3 test, the 4Kscore, and ExoDx, noting their promise but emphasizing that calibration in Black men remains incomplete. He also reviews MRI-informed risk assessment, reporting published data that sensitivity and negative predictive value are lower in Black men compared to non-Black men. These findings suggest that widely used thresholds may not be appropriate for high-risk groups.

Dr. Murphy concludes that recalibration of biomarkers and imaging tools, combined with large-scale validation studies across diverse populations, is needed to ensure equitable risk assessment and improved outcomes.
Categoria
Oncology
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