New prostate screening guidelines organized by the Prostate Cancer Foundation aim to address the longstanding health disparity in prostate cancer: Black men are diagnosed with and die from prostate cancer at a much higher rate than white men.
And the stats are alarming. According to the American Cancer Society, Black men are 70% to 110% more likely to develop prostate cancer in their lifetime and twice as likely to die from the disease.
In an effort to help reduce these disparities, a panel of diverse, interdisciplinary experts was formed to establish practical guidelines addressing prostate-specific antigen (PSA)-based screening in Black men.
These new guidelines, which most notably include having baseline PSA testing starting between the ages of 40-45, were presented by Isla Garraway, MD, PhD, professor and director of research in urology at the David Geffen School of Medicine at UCLA and scientist in the UCLA Health Jonsson Comprehensive Cancer Center, during the 2024 ASCO Genitourinary Cancers Symposium in San Francisco.
To develop the guidelines, the panel performed a comprehensive literature search that was conducted in April 2023 using PubMed and Embase databases. A total of 287 studies were reviewed.
Through the review, the panel developed six guideline statements:
1. Since Black men are at high risk for prostate cancer, the benefits of screening generally outweigh the risks.
2. PSA is a blood test that should be considered first-line for prostate cancer screening.
3. Decisions about PSA testing depend on individual preferences.
4. For Black men who elect screening, a baseline PSA test should be done between ages 40-45.
5. Black men over the age of 70 who have been undergoing prostate cancer screenings should talk with their health care provider about whether to continue PSA testing.
6. Black men with an even higher risk of prostate cancer due to strong family history should consider annual PSA screening as early as age 40.
