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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
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Prostate Cancer Screening Practices Among High-Risk Patients: A Retrospective Analysis
Aditya K Ghosh1, Barath P Sivasubramanian2, Rana H Asif2
1Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
American Journal of Men'S Health
|November 20, 2025
Summary
Prostate-specific antigen (PSA) screening for prostate cancer is inconsistent in primary care. While more risk factors increase testing, African American and low-income men remain under-tested, highlighting a need for improved screening equity.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Prostate cancer is a leading cancer in U.S. men, disproportionately affecting African Americans.
- Guidelines recommend early detection via prostate-specific antigen (PSA) screening, but its application in primary care is inconsistent.
- Understanding screening patterns and risk factor associations is crucial for improving outcomes.
Purpose of the Study:
- To assess prostate-specific antigen (PSA) screening patterns in primary care.
- To analyze the association between patient risk factors and PSA testing rates.
- To identify disparities in prostate cancer screening.
Main Methods:
- Retrospective analysis of 176,326 men aged 40+ from primary care clinics (2020-2022).
- Development of risk scores based on prostate cancer risk factors.
- Univariate and multivariate analyses to examine associations between risk scores, PSA screening, and cancer diagnosis.
Main Results:
- Only 31.4% of patients received PSA testing; testing rose to 78.1% with a risk score of 4.
- Higher odds of PSA testing were associated with Medicaid/commercial insurance, former/never smoking status, older age, African American race, and family history.
- Prostate cancer diagnosis occurred in 25% of patients with a risk score of 5, predicted by older age, African American race, and family history.
Conclusions:
- Prostate-specific antigen (PSA) screening is underutilized in primary care, even for high-risk individuals.
- While risk factors correlate with increased testing, disparities persist, with African American and low-income populations being under-tested.
- Provider education and decision-support tools are recommended to enhance guideline adherence and promote equitable screening.
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