The goal of prostate cancer screening is to detect it early and find it before it spreads and causes symptoms.
Late detection can lead to a higher risk of the cancer spreading.
There is a higher risk of prostate cancer death if you are African-American or have a family history of prostate cancer.
Black men are also diagnosed with and die from prostate cancer at a much higher rate than white men.
However, new prostate screening guidelines organized by the Prostate Cancer Foundation aim to address this long-standing health disparity.
This article will discuss how prostate cancer is typically screened, the recommendations in the new guidelines, and the importance of screening for Black men.
New Guidelines Suggest Black Men Should Be Screened For Prostate Cancer From 40-45
According to the American Cancer Society, it is recommended that men of average risk should start discussing prostate cancer screening between the ages of 50-55.
However, these current guidelines don’t account for the higher rates and high likelihood of at-risk groups.
For example, Black men are 70% to 110% more likely to develop prostate cancer in their lifetime and twice as likely to die from the disease.
One suggestion to modify the guideline is to start discussions about prostate cancer earlier, around the age of 45. In some instances, men at the highest risk may consider starting screening as early as age 40.
Additionally, an expert panel developed six new guideline statements addressing screening for Black men:
- PSA testing should be considered first-line for prostate cancer screening, even when an optional digital rectal exam is required in addition to the PSA test.
- Due to the higher risk of prostate cancer in Black men, the benefits of screening generally outweigh the risks.
- Black men who are at even higher risk due to strong family history or known carriers of high-risk genetic variants should consider initiating annual PSA screening as early as age 40.
- An annual PSA screening should be considered based on the individual’s health status and PSA value. For Black men who opt for screening, a baseline PSA test should be done between ages 40 and 45.
- Black men over age 70 who have been undergoing prostate cancer screening should talk with their healthcare provider about it. Together, you can decide whether to continue PSA testing based on factors such as your age, health condition, family history, and previous PSA levels.
- Black men should make shared decisions with their healthcare providers and other trusted sources of information to learn about the pros and cons of screening.
The outcome of these more directed guidelines will be to give clarity to these men when they go from screening.
The expert suggestions tally with the best available evidence and show that Black men could benefit from a risk-adapted PSA screening.
Who Is At A Higher Risk Of Having Prostate Cancer?
Ethnicity
Black men have a higher risk of developing prostate cancer compared to men of other ethnicities.
Family History
Those with a close family member diagnosed with prostate cancer before the age of 65 have an increased risk.
You are two and a half times more likely to get prostate cancer if your father or brother has a history of it.
Age
60% of prostate cancers are found in men older than 65. The chance of having prostate cancer increases after 50 years.
Specific gene changes
Variants or mutations in genes inherited from a parent can raise prostate cancer risk. Mutations, such as BRCA1 and BRCA2, may increase the risk of developing prostate cancer.
Therefore, the guidelines should be modified for individuals at a higher risk to improve health equity.
Why Do Black Men Have Higher Rates Of Prostate Cancer?
Black men are disproportionately affected by prostate cancer due to several reasons.
One reason could be cultural factors, including general mistrust of the healthcare system, poor physician‐patient communication, and lack of information.
Also, depending on their socioeconomic status, they may not get screened as vigilantly as white and Asian men, leading to more advanced cancer diagnoses and worse outcomes.
Black men are considered a high-risk population for being diagnosed with and dying from prostate cancer due to the following:
- The history of segregation and mistreatment in the health care system may contribute to mistrust among Black men.
- Outcomes are worse for Black men because they are less likely to be screened or to receive treatment for prostate cancer.
- Black men are less likely to participate in clinical research, making it difficult for investigators to understand how Black men are affected by prostate cancer.
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Conclusion
- All men are at risk for prostate cancer as they grow older. However, Black men are at a higher risk of developing and dying from prostate cancer.
- This disparity has prompted new guidelines recommending early discussions about screening and getting screened regularly.
- It also encourages open communication between Black men and their healthcare providers.
- By adjusting screening practices, these guidelines aim to reduce health disparities and improve outcomes. It also ensures more effective access to screening and treatment.
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