Prostate Cancer Screening in African American Men: A Review of the Evidence.

Kensler KH, Johnson R, Morley F, Albrair M, Dickerman BA, Gulati R, Holt SK, Iyer HS, Kibel AS, Lee JR, Preston MA, Vassy JL, Wolff EM, Nyame YA, Etzioni R, Rebbeck TR. Prostate Cancer Screening in African American Men: A Review of the Evidence. Journal of the National Cancer Institute. 2023 Sep 15.

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Abstract:

BACKGROUND: Prostate cancer (PC) is the most diagnosed cancer in African American men (AAM), yet PC screening regimens in this group are poorly guided by existing evidence, given underrepresentation of AAM in prostate cancer screening trials. It is critical to optimize PC screening and early detection in this high-risk group since underdiagnosis may lead to later stage cancers at diagnosis and higher mortality while overdiagnosis may lead to unnecessary treatment. METHODS: We performed a review of the literature related to PC screening and early detection specific to AAM to summarize the existing evidence available to guide healthcare practice. RESULTS: Limited evidence from observational and modeling studies suggests that AAM should be screened for PC. Consideration should be given to initiating screening AAM at younger ages (eg, 45-50?years) and at more frequent intervals relative to other racial groups in the U.S. Screening intervals may be optimized through use of a baseline PSA measurement in midlife. Lastly, no evidence indicated that AAM would benefit from screening beyond age 75?years, and AAM may experience higher rates of overdiagnosis at older ages. CONCLUSIONS: The evidence base for PC screening in AAM is limited by the lack of large, randomized studies. Our literature search supported the need for AAM to be screened for PC, for initiating screening at younger ages (45-50?years) and perhaps at more frequent intervals among AAM relative to men of other racial groups in the U.S.