African American males between ages 45 and 60 have a higher rate and probability of prostate specific antigen (PSA) screening than non-Hispanic white males in the U.S., despite long-standing disparities in healthcare access and a prostate cancer mortality rate more than twice that of their white counterparts, a study reported.
The study, titled “Determinants of Prostate Specific Antigen Screening among Black Men in the United States in the Contemporary Era,” was published in The Journal of Urology.
Although black men have the highest rate of prostate cancer and shorter survival time compared to other racial or ethnic group in the U.S., recommendations from professional medical bodies and the United States Preventive Services Task Force (USPSTF) regarding PSA screenings in this population are still unclear. Early diagnosis through PSA screening can help decrease resultant morbidity and mortality.
Jesse D. Sammon from the Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, and colleagues assessed the prevalence of self-reported PSA screening by evaluating data retrieved from the Behavioral Risk Factor Surveillance System (BRFSS) 2012 survey. They observe that black men between the age range of 45 to 60 years old have a higher rate and probability of PSA screening compared to non-Hispanic whites (NHWs).
“While data suggest that PSA screening may afford survival benefit for black men, the lack of unanimity among national guidelines when and whether to screen black men presents a challenge to providing the best care for this group and is perplexing for health care providers,” Jesse D. Sammon, DO, of Henry Ford Hospital, Detroit, the Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, and the study’s lead investigator, said in a news release.
Results revealed that in 2012 there were 122,309 survey respondents in the study population, of which 29 percent of black and 32 percent of non-Hispanic white men reported undergoing prostate specific antigen screening. Younger black males had higher rates and odds of screening than non-Hispanic white men of similar ages. Among black men, only a higher education level (graduates versus non-graduates), regular access to a healthcare provider, and a provider’s recommendation for screening were independently associated with prostate specific antigen screening.
“PSA testing among young black men has increased steadily since the 1990s, and our results point towards continuation of this trend. Contrary to our initial hypothesis, significantly fewer black males reported PSA screening than NHWs, but black males aged 45-60 have a higher rate and probability of PSA screening compared to NHWs,” Dr. Sammon said.
According to Dr. Sammon and his colleagues, “Earlier PSA testing may allow diagnosis of lower risk prostate cancer in black men, and greater decline in prostate cancer-specific mortality has been noted for black versus NHW men since the PSA test was introduced in the 1990s. The increased odds for screening in young black men, as demonstrated in our results, may reflect increased perception of this high risk group within the health care community and/or access to more equitable health care systems (such as the Veterans Health Administration).”