{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:21:26Z","timestamp":1788182486751,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>On a population level, black patients have more prostate cancer (PC), particularly aggressive PC. Similarly, on initial biopsy, black race has been linked with higher PC and high\u2010grade PC risk. Whether this extends to first repeat biopsy is unknown. We tested if black race predicts PC risk, grade, and biopsy compliance within a phase 3 PC prevention trial with study\u2010mandated biopsies among patients with an initial negative prestudy biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Analysis of 7445 patients (2.4% black, 97.6% white) from REDUCE, a 4\u2010year, double\u2010blind, placebo\u2010controlled trial testing dutasteride versus placebo on PC risk. Patients had a single, negative, prestudy biopsy, PSA 2.5\u201310\u2009ng\/mL, and study\u2010mandated biopsies at 2 and 4\u2010years. Multivariable logistic and multinomial regressions were used to test if self\u2010reported race predicted PC, grade (low, Grade\u2010Group 1 [GG1] vs. high, Grade\u2010Group &gt;\u20092 [GG2+]), and biopsy compliance. Given concerns about noncompliance affecting analyses, primary analyses for PC examined 2\u2010year biopsy outcomes among patients who underwent biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On multivariable analysis, black patients were less likely to receive the 2\u2010year biopsy (OR: 0.53, 95%CI: 0.39\u20130.74), but had higher PC risk, which approached, but did not reach significance (OR 1.56, 95%CI: 0.98\u20132.46). When stratified by grade, on multivariable analysis, black race was unrelated to GG1 (RRR: 1.17, 95%CI: 0.65\u20132.12) but associated with GG2\u2009+\u2009PC (RRR: 2.44, 95%CI: 1.29\u20134.64) at the 2\u2010year biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with a negative prestudy biopsy on a phase 3 trial, black patients had lower compliance with study\u2010mandated biopsy but were 2.44 times more likely to have GG2\u2009+\u2009PC on the 2\u2010year biopsy versus white patients. These data extend population and initial biopsy data to first repeat biopsy, strongly supporting that black race is linked with aggressive PC. Given differential biopsy compliance may be greater in the real\u2010world, these data suggest population data may underestimate true racial disparities in PC risk and aggressiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70241","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:01:06Z","timestamp":1788181266000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Black Race Predicts Poor Compliance and Higher Prostate Cancer Risk in a Multinational Repeat Biopsy Cohort: Secondary Analysis From the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) Clinical Trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5277-5113","authenticated-orcid":false,"given":"Alexis R.","family":"Freedland","sequence":"first","affiliation":[{"name":"Cedars\u2010Sinai Cancer Center, Cedars\u2010Sinai Medical Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Moriera","sequence":"additional","affiliation":[{"name":"Department of Urology University of Illinois College of Medicine at Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Gong","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Cancer Center, Cedars\u2010Sinai Medical Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8104-6419","authenticated-orcid":false,"given":"Stephen J.","family":"Freedland","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Cancer Center, Cedars\u2010Sinai Medical Center Los Angeles California USA"},{"name":"Department of Surgery Durham Veterans Affairs Medical Center Durham North Carolina USA"},{"name":"Department of Urology Cedars Sinai Medical Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","first-page":"17","article-title":"Cancer Statistics, 2023","volume":"73","author":"Siegel R. L.","year":"2023","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"8","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1007\/s10552-014-0402-6","article-title":"The Association Between Race and Prostate Cancer Risk on Initial Biopsy in an Equal Access, Multiethnic Cohort","volume":"25","author":"Gaines A. R.","year":"2014","journal-title":"Cancer Causes & Control"},{"issue":"5","key":"e_1_2_11_4_1","first-page":"7496","article-title":"Temporal Trends and Racial Disparities in Global Prostate Cancer Prevalence","volume":"21","author":"Rebbeck T. R.","year":"2014","journal-title":"Canadian Journal of Urology"},{"issue":"1","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.eururo.2022.11.023","article-title":"Disparities and Trends in Genitourinary Cancer Incidence and Mortality in the USA","volume":"84","author":"Schafer E. J.","year":"2023","journal-title":"European Urology"},{"issue":"1","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.euo.2021.07.006","article-title":"Prostate Cancer Racial Disparities: A Systematic Review by the Prostate Cancer Foundation Panel","volume":"5","author":"Mahal B. A.","year":"2022","journal-title":"European Urology Oncology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34979"},{"issue":"2","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1038\/pcan.2016.5","article-title":"Baseline Subject Characteristics Predictive of Compliance With Study\u2010Mandated Prostate Biopsy in Men at Risk of Prostate Cancer: Results From REDUCE","volume":"19","author":"Fischer S.","year":"2016","journal-title":"Prostate Cancer and Prostatic Diseases"},{"issue":"2","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1038\/s41391-022-00613-7","article-title":"Ethnic Differences in Prostate\u2010Specific Antigen Levels in Men Without Prostate Cancer: A Systematic Review","volume":"26","author":"Barlow M.","year":"2023","journal-title":"Prostate Cancer and Prostatic Diseases"},{"issue":"21","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"3787","DOI":"10.1002\/cncr.34433","article-title":"Racial Disparities in Black Men With Prostate Cancer: A Literature Review","volume":"128","author":"Lillard J. W.","year":"2022","journal-title":"Cancer"},{"issue":"5","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1056\/NEJM199608013350502","article-title":"Age\u2010Specific Reference Ranges for Serum Prostate\u2010Specific Antigen in Black Men","volume":"335","author":"Morgan T. O.","year":"1996","journal-title":"New England Journal of Medicine"},{"issue":"13","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1056\/NEJMoa0908127","article-title":"Effect of Dutasteride on the Risk of Prostate Cancer","volume":"362","author":"Andriole G. L.","year":"2010","journal-title":"New England Journal of Medicine"},{"issue":"3","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1056\/NEJMoa030660","article-title":"The Influence of Finasteride on the Development of Prostate Cancer","volume":"349","author":"Thompson I. M.","year":"2003","journal-title":"New England Journal of Medicine"},{"issue":"3","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.1839","article-title":"Geographic Distribution of Racial Differences in Prostate Cancer Mortality","volume":"3","author":"Fletcher S. A.","year":"2020","journal-title":"JAMA Network Open"},{"issue":"11","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1002\/pros.23540","article-title":"Secondary Prostate Cancer Screening Outcomes by Race in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Screening Trial","volume":"78","author":"Miller E. A.","year":"2018","journal-title":"Prostate"},{"issue":"8","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1158\/1055-9965.EPI-14-0202","article-title":"Factors Associated With Adherence to an End\u2010of\u2010Study Biopsy: Lessons From the Prostate Cancer Prevention Trial (SWOG\u2010Coordinated Intergroup Study S9217)","volume":"23","author":"Gritz E. R.","year":"2014","journal-title":"Cancer Epidemiology, Biomarkers & Prevention"},{"issue":"13","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1056\/NEJMoa0810696","article-title":"Mortality Results From a Randomized Prostate\u2010Cancer Screening Trial","volume":"360","author":"Andriole G. L.","year":"2009","journal-title":"New England Journal of Medicine"},{"issue":"3","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/0197-2456(94)00XXX-M","article-title":"Design of the Prostate Cancer Prevention Trial (PCPT)","volume":"16","author":"Feigl P.","year":"1995","journal-title":"Controlled Clinical Trials"},{"issue":"3","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/(SICI)1097-0045(19971101)33:3<217::AID-PROS11>3.0.CO;2-N","article-title":"Chemoprevention of Prostate Cancer: The Prostate Cancer Prevention Trial","volume":"33","author":"Thompson I. M.","year":"1997","journal-title":"Prostate"},{"issue":"2","key":"e_1_2_11_20_1","first-page":"589","article-title":"A National Cancer Institute Sponsored Screening Trial for Prostatic, Lung, Colorectal, and Ovarian Cancers","volume":"71","author":"Kramer B. S.","year":"1993","journal-title":"Cancer"},{"issue":"7","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1007\/s10552-010-9535-4","article-title":"Racial Differences in PSA Screening Interval and Stage at Diagnosis","volume":"21","author":"Carpenter W. R.","year":"2010","journal-title":"Cancer Causes & Control"},{"issue":"4","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.eururo.2022.03.007","article-title":"Deconstructing, Addressing, and Eliminating Racial and Ethnic Inequities in Prostate Cancer Care","volume":"82","author":"Nyame Y. A.","year":"2022","journal-title":"European Urology"},{"issue":"11","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"501.e1","DOI":"10.1016\/j.urolonc.2018.06.011","article-title":"Self\u2010Reported Black Race Predicts Significant Prostate Cancer Independent of Clinical Setting and Clinical and Socioeconomic Risk Factors","volume":"36","author":"Nettey O. S.","year":"2018","journal-title":"Urologic Oncology: Seminars and Original Investigations"},{"issue":"4","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1111\/j.1464-410X.2006.06388.x","article-title":"African\u2010American Race Is a Predictor of Prostate Cancer Detection: Incorporation Into a Pre\u2010Biopsy Nomogram","volume":"98","author":"Yanke B. V.","year":"2006","journal-title":"BJU International"},{"issue":"10","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1056\/NEJMoa1910038","article-title":"MRI\u2010Targeted, Systematic, and Combined Biopsy for Prostate Cancer Diagnosis","volume":"382","author":"Ahdoot M.","year":"2020","journal-title":"New England Journal of Medicine"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70241","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pros.70241","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:01:10Z","timestamp":1788181270000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":24,"alternative-id":["10.1002\/pros.70241"],"URL":"https:\/\/doi.org\/10.1002\/pros.70241","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"2025-03-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pros.70241"}}