Lower PHI, [-2]proPSA/fPSA and testosterone/estradiol ratios in healthy black men: preliminary results and potential implications in prostate cancer clinical management.

Background: Black men residing in Western countries are more likely to develop prostate cancer (PCa), have higher mortality and are younger than the general population at initial diagnosis. In addition to genetic and environmental factors, the reasons for these racial disparities can also be attributed to social determinants of health such as low health literacy of this population and poor awareness of health services. Little is known about laboratory tests for PCa in black men.

Methods: In this preliminary study. we investigated whether ethnicity affect PSA molecular forms, PHI, estradiol and testosterone levels in healthy men.

Results: We found that healthy black men had lower PHI, [-2]proPSA/fPSA and testosterone/estradiol ratios.

Conclusions: Our findings even if on a small study population could have a relevant clinical impact. since PCa screening is particularly relevant in black men who are at high risk of clinically significant PCa. PSA-based screening is needed and overdiagnosis must be avoided. Our findings could be particularly impactful. Future research on larger population needs to consider whether ethnicity specific laboratory tests thresholds could help to reduce the ethnic inequalities in prostate cancer diagnosis.