Purpose: The accuracy of prostate specific antigen (PSA) to detect prostate cancer has not yet been determined. Autopsy evidence suggests one-third of men have evidence of prostate cancer. Correlation between prostate cancer and sexually transmitted infection is indeterminate. Materials and Methods: A retrospective database was created of all men who underwent transrectal ultrasound guided prostate biopsy over 3 years. Men were 49% African or African Caribbean, and 51% Central or South American. Information about prostate specific antigen, cholesterol, hepatitis A, B and C, human immunodeficiency virus, syphilis, tuberculin skin testing and histology were collected. Results: Hepatitis C antibody detection correlated with prostate cancer OR 11.2 (95% CI 3.0 to 72.4). The odds of prostate cancer increased annually (p = 0.0003). However, no correlation was found between prostate cancer and the following: PSA, biopsy date, repeat biopsy, more than 12 cores at biopsy, total cholesterol, high density lipoprotein, triglycerides, low density lipoprotein, risk measure reported with free and total PSA, hepatitis B surface antibody, high grade prostatic intraepithelial neoplasia or atypical small acinar proliferation. Histologic prostatitis and basal cell hyperplasia were inversely correlated with prostate cancer. Syphilis of unknown duration occurred in 17% of men with indeterminate correlation to prostate cancer. Conclusion: In inner city men of African and African-Caribbean, or Central and South American descent, prostate specific antigen levels did not correlate with prostate cancer. Hepatitis C antibody detection correlates significantly with prostate cancer. One prostate biopsy is sufficient to diagnose statistically significant prostate cancer. Histologic prostatitis and basal cell hyperplasia decrease odds of prostate cancer. Atypical small acinar proliferation may not correlate to prostate cancer and is pending further investigation. Men should be screened for epidemic syphilis of unknown duration.

Background: An analysis of the Prostate Cancer Database Project previously identified an association between hepatitis C antibody testing and prostate cancer (Pca). Methods: The records of 864 African American (AA) and Hispanic men from January 1, 2000, thru July 31, 2011 with both prostate biopsy and hepatitis C antibody testing were examined. Chi-squared tests, T-tests of difference and logistic regression models were used to interpret data. A skill plot was used to integrate receiver operating curves and optimal cut-off for PSA in accordance with Bayesian theory. Results: Seventy percent of AA men and 52% of Hispanic men with hepatitis C antibody testing had Pca, while 68% of AA and 70% of Hispanic men with hepatitis C antibody detected had Pca. African American men had significantly higher rates of Pca, hepatitis C antibody detected, HIV, and higher cancer stage at diagnosis when compared to Hispanic men. Prostate cancer was more likely to metastasize despite average histological Gleason scores of less than 7 and was not related to number of cancer containing cores at biopsy. PSA did not meet criteria required of standard screening tests to detect Pca in this patient population. Conclusions: In New York City, African American and Hispanic men referred for prostate biopsy with a history of hepatitis C antibody detection or indication for testing have the highest rates of Pca detected in any group identified to date, with high rates of metastatic disease at presentation independent of PSA, histological Gleason scores and number of cores containing cancer at diagnostic biopsy. The presence of serum hepatitis C antibody significantly increases odds of Pca.

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