High grade prostate intraepithelial neoplasia (PIN) is a PSA-independent risk factor for prostate cancer in African American men: Results from a pilot study

African American men (AAM) demonstrate increased prostate cancer incidence and mortality rates. We investigated known prostate cancer risk factors in AAM. Prostate specific antigen (PSA) and diagnosis of high grade prostatic intraepithelial neoplasia (PIN) were significant prostate cancer predictors. However, even including AAM with low PSA (<4 ng/ml), those with PIN had significantly elevated risk, compared to men without PIN (83.3% vs. 6.9%, p < 0.0001). In AAM diagnosed with PIN, PSA level was no longer significant (83.3% vs. 92.3%, p = 0.593 respectively). Our results suggest that a history of PIN is highly predictive of prostate cancer in AAM, and help provide PSA-independent venues for screening.

► High grade prostatic intraepithelial neoplasia (PIN) is a significant prostate cancer predictor in African American men.
► In African American men diagnosed with PIN, prostate specific antigen (PSA) score is no longer a significant prostate cancer predictor.
► Our results highlight the difference in prostate cancer biology between populations, and help provide PSA-independent venues for early detection.