Racial differences in PSA screening interval and stage at diagnosis

Area of Science:

• Oncology
• Public Health
• Health Disparities

Background:

• Prostate cancer screening in older men is crucial for early detection.
• Racial disparities exist in prostate cancer diagnosis and outcomes.
• Prostate-specific antigen (PSA) screening intervals may influence cancer stage at diagnosis.

Purpose of the Study:

• To investigate the association between PSA screening intervals and prostate cancer stage at diagnosis in Black and White men aged 65 or older.
• To determine if PSA screening patterns contribute to racial differences in advanced prostate cancer diagnosis.

Main Methods:

• Analysis of SEER-Medicare data for 18,067 Black and White men diagnosed with prostate cancer (1994-2002).
• Logistic regression to assess the relationship between race, PSA screening interval, and cancer stage.
• Controlled for demographic, clinical, and socioeconomic factors.

Main Results:

• Black men were more likely to have longer PSA screening intervals and less frequent screening prior to diagnosis compared to White men.
• Adjusting for PSA screening interval reduced the odds of advanced-stage prostate cancer diagnosis in Black men, diminishing racial differences.
• Longer intervals between PSA tests were consistently linked to a higher likelihood of advanced disease at diagnosis.

Conclusions:

• More frequent or systematic PSA screening could be a strategy to reduce racial disparities in prostate cancer stage at diagnosis.
• Reducing diagnostic stage differences may, in turn, help decrease prostate cancer mortality rates among Black men.