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Increased Severity of Prostate Cancer Presentation in an Appalachian Cohort Compared to National Data

About this Publication
Title
Increased Severity of Prostate Cancer Presentation in an Appalachian Cohort Compared to National Data
Digital Object Identifier
Publication
Clinical Genitourinary Cancer. 2025 May 21; Volume 0 (Issue 0): Pages 102375
Authors
Marvin A. Simpkins, Garrett Douglas, Emily Yablonsky, Lawrence Wyner, Justyn Blankenship
Affiliations
  • Joan C Edwards School of Medicine, Huntington & WV, Department of Urology, Joan C Edwards School of Medicine, Huntington, WV
Abstract

Micro-Abstract

Background: Data on prostate cancer presentation in Appalachia are scarce. Methods: We retrospectively reviewed 160 first-time transrectal ultrasound-guided prostate biopsies from 2022–2024 at a single Appalachian institution and compared them to 8,776 positive biopsies from the PLCO trial. Gleason scores were grouped as Grade Group 1 (≤6), 2/3 (7), 4 (8), and 5 (≥9). We used chi-square tests, Wilcoxon rank-sum tests, and sequential logistic regression to analyze grade distributions, age, and PSA differences. Results: Appalachian patients had higher rates of Grade Group 4 (19.1% vs. 7.9%) and Grade Group 5 disease (10.1% vs. 5.0%), older median age (e.g., Grade 1: 66 vs. 63 years, p = 0.0033), and higher median PSA (e.g., Grade 1: 8.6 vs. 5.7 ng/mL, p = 0.0001). In fully adjusted models, Grade 4 (OR 2.54, p = 0.002) and Grade 5 (OR 2.80, p = 0.002) remained independent predictors of Appalachian cohort membership. Conclusions: Appalachian patients exhibit a disproportionately high prevalence of advanced-grade prostate cancer, underscoring the need for region-specific early detection strategies.

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