PD50-10 AFRICAN AMERICAN RACE IS NOT ASSOCIATED WITH RECLASSIFICATION DURING ACTIVE SURVEILLANCE: RESULTS FROM THE CANARY PROSTATE CANCER ACTIVE SURVEILLANCE STUDY (PASS)
Bibliographic record
Abstract
You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD50)1 Apr 2019PD50-10 AFRICAN AMERICAN RACE IS NOT ASSOCIATED WITH RECLASSIFICATION DURING ACTIVE SURVEILLANCE: RESULTS FROM THE CANARY PROSTATE CANCER ACTIVE SURVEILLANCE STUDY (PASS) Jeannette M. Schenk, Anna V. Faino, Lisa F. Newcomb*, James D. Brooks, Peter R. Carroll, Atreya Dash, Christopher P. Filson, Martin E. Gleave, Michael Liss, Francis M. Martin, Todd M. Morgan, Peter S. Nelson, Ian M. Thompson, Andrew A. Wagner, and Daniel W. Lin Jeannette M. SchenkJeannette M. Schenk More articles by this author , Anna V. FainoAnna V. Faino More articles by this author , Lisa F. Newcomb*Lisa F. Newcomb* More articles by this author , James D. BrooksJames D. Brooks More articles by this author , Peter R. CarrollPeter R. Carroll More articles by this author , Atreya DashAtreya Dash More articles by this author , Christopher P. FilsonChristopher P. Filson More articles by this author , Martin E. GleaveMartin E. Gleave More articles by this author , Michael LissMichael Liss More articles by this author , Francis M. MartinFrancis M. Martin More articles by this author , Todd M. MorganTodd M. Morgan More articles by this author , Peter S. NelsonPeter S. Nelson More articles by this author , Ian M. ThompsonIan M. Thompson More articles by this author , Andrew A. WagnerAndrew A. Wagner More articles by this author , and Daniel W. LinDaniel W. Lin More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556885.55209.5fAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Recent studies have reported that African American (AA) men are at an increased risk of progression on Active Surveillance (AS) compared to Caucasians (CA). However, many of these studies are based on relatively few AA, have limited follow-up and may be subject to detection biases related to compliance with AS regimens or biopsy recommendations. The objective of this study was to evaluate whether race is associated with risk of reclassification in a well-established prospective AS cohort that utilizes protocol-driven PSA measurements and surveillance biopsies. METHODS: Data are from the multicenter Canary Prostate Active Surveillance Study (PASS). PSAs are collected every 3 months and surveillance biopsies are protocol-recommended at 6-12 months after initial diagnosis, 24 months, and every 2 years thereafter. Men included in this study had Gleason grade 3+3 or 3+4 at diagnosis, < 5 years between diagnosis and enrollment, and had undergone ≥ 1 surveillance biopsy. Cox proportional hazards models were used to examine differences between AA and CA men and time to reclassification, defined as an increase in Gleason score on subsequent biopsy and adverse pathology at prostatectomy, defined as pT3a or greater or Gleason grade group 3 or greater. RESULTS: Of the 1,315 men in this study, 89(7%) were AA and 1,226(93%) were CA. Compared to CA, AA had significantly higher median PSA and PSA density at diagnosis (5.6 vs 4.9, p<0.001; 0.14 vs 0.11, p=0.01). Overall treatment rates were comparable between AAs and CAs, though AAs were more likely to undergo radiation and CAs were more likely to undergo radical prostatectomy (57% vs 38% and 56% vs 43%, respectively, p>0.05 for both). In multivariate models adjusted for diagnostic biopsy and clinical variables, AA race was not significantly associated with the risk of reclassification (HR=1.16, p=0.45). Among men who had a prostatectomy, the rate of adverse pathology was similar for AA and CA (31% vs 27%, p=0.76). CONCLUSIONS: In a prospective cohort of men on AS who follow a standardized protocol of regular PSA and biopsy, AA race was not associated with risk of adverse pathologic reclassification or adverse pathology at prostatectomy. These results provide support for the choice of AS for AA men and suggest that biases related to racial disparity in screening, access to care, and patterns of treatment may contribute to conflicting results from prior studies. Source of Funding: Canary Foundation; DoD W81XWH1410595 Seattle, WA; Palo Alto, CA; San Francisco, CA; Seattle, WA; Atlanta, GA; Vancouver, Canada; San Antonio, TX; Virginina Beach, VA; Ann Arbor, MI; Seattle, WA; San Antonio, TX; Boston, MN; Seattle, WA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e916-e916 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeannette M. Schenk More articles by this author Anna V. Faino More articles by this author Lisa F. Newcomb* More articles by this author James D. Brooks More articles by this author Peter R. Carroll More articles by this author Atreya Dash More articles by this author Christopher P. Filson More articles by this author Martin E. Gleave More articles by this author Michael Liss More articles by this author Francis M. Martin More articles by this author Todd M. Morgan More articles by this author Peter S. Nelson More articles by this author Ian M. Thompson More articles by this author Andrew A. Wagner More articles by this author Daniel W. Lin More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".