Rising metastatic prostate cancer rates but narrowing racial gap

Area of Science:

• Oncology
• Public Health
• Health Disparities

Background:

• Racial disparities in prostate cancer (PCa) care, including screening, are a significant concern.
• Recent interest focuses on understanding and addressing these disparities, particularly in risk-adapted screening strategies.

Purpose of the Study:

• To examine trends in metastatic PCa incidence by race.
• To contextualize these trends with changes in prostate-specific antigen (PSA) screening recommendations and uptake.

Main Methods:

• Analysis of metastatic PCa incidence data by race (2005-2021) using SEER data.
• Analysis of PSA screening trends (2012-2020) using BRFSS data.
• Generalized linear models were used to assess racial incidence rate ratios and screening odds ratios for Non-Hispanic Black (NHB) versus Non-Hispanic White (NHW) men.

Main Results:

• Metastatic PCa incidence increased in both NHB and NHW men from 2005-2021.
• The racial gap in incidence narrowed, with the NHB vs. NHW incidence rate ratio declining from 2.6 to 2.1.
• PSA screening declined in both groups from 2012-2020, with a steeper decline among NHB men, leading to no significant difference by 2020.

Conclusions:

• The racial disparity in metastatic PCa narrowed during the study period, coinciding with increased overall incidence.
• Higher PSA screening rates among NHB men in the early 2010s likely contributed to the narrowing gap.
• A more rapid decline in screening among NHB men raises concerns about a potential resurgence of racial disparities in the future.