Black men in the United States are more likely to develop prostate cancer than white men, and after diagnosis, they’re more likely to have advanced disease and to die than white men with the disease.
Although it would seem that earlier prostate‐specific antigen (PSA) screening could reduce the risk of fatal prostate cancer in black men, new research indicates that at any given PSA level, black men are more likely to harbor prostate cancer than white men, indicating that they may face an increased risk of prostate cancer than white men at lower PSA levels. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
For the study, researchers used models to predict the likelihood of prostate cancer diagnosis from a first biopsy for 75,295 black and 207,658 white male Veterans receiving care from the U.S. Department of Veterans Affairs (VA). Prostate cancer was detected in the first prostate biopsy in 55% of black men and in 43% of white men. After taking various competing factors into account, black Veterans were 50% more likely to receive a prostate cancer diagnosis based on their first prostate biopsy than white Veterans.
Also, black men with a pre-biopsy PSA of 4.0 ng/mL had a 49% risk of prostate cancer detected during their biopsy, compared with a 39% risk for white men with the same PSA level. The investigators’ model indicated that black Veterans with a PSA of 4.0 ng/mL had an equivalent risk of prostate cancer as white Veterans with a PSA of 13.4 ng/mL.
