Prostate Cancer Foundation Screening Guidelines for Black Men in the United States

Area of Science:

• Oncology
• Public Health
• Preventive Medicine

Background:

• Black men experience disproportionately high rates of prostate cancer diagnosis and mortality in the U.S.
• Existing screening guidelines may not adequately address the specific risks faced by this demographic.

Purpose of the Study:

• To establish clinical prostate-specific antigen (PSA) screening guidelines tailored for Black men in the United States.
• To address the significant health disparity in prostate cancer outcomes.

Main Methods:

• A systematic literature search adhering to PRISMA guidelines identified 264 relevant studies.
• Analysis included randomized controlled trials, observational studies, and modeling studies.
• Evidence was synthesized to inform age, frequency, and cessation of PSA screening.

Main Results:

• Level 1 evidence shows PSA screening for average-risk men aged 50-74 reduces metastasis and death.
• Observational and modeling studies indicate prostate cancer develops 3-9 years earlier in Black men.
• Lowering baseline PSA testing to ages 40-45 and regular screening until 70 could reduce mortality by ~30% without significant overdiagnosis.

Conclusions:

• Black men should be informed about prostate cancer PSA screening options.
• Baseline PSA testing should commence between ages 40 and 45 for Black men who opt for screening.
• Annual screening should be strongly considered based on PSA levels and health status.