By Ann Miller Baker
Prostate cancer is the second most common cancer in American men. But black men bear a disproportionate burden of its effects. It’s more common – and more than twice as deadly – among black men compared to their white counterparts. Yet the United States Preventive Services Task Force (USPSTF) recommendations for prostate cancer screening do not differentiate for race, leaving it to physicians and patients, ages 55 to 69, to reach an individual decision on whether and when to screen.
In a new study, researchers demonstrated that a baseline prostate-specific antigen (PSA) level obtained from black men between ages 40 and 60 can strongly predict future development of prostate cancer and its most aggressive forms for years after testing.
The results showed that the risk of prostate cancer rose along with rising PSA levels, regardless of age. Importantly, the results showed that, for men aged 40 to 54, PSA levels within the “normal” range that would not trigger a follow-up in usual clinical practice (1.1 – 1.7 ng/ml) still saw an increased risk for prostate cancer.
“Midlife PSA predicts subsequent development of aggressive prostate cancer better than either family history or race,” said co-first author and Moffitt epidemiologist Travis Gerke, Sc.D.
“While these findings do not imply that these younger men should immediately undergo prostate biopsy or definitive treatment, they suggest that this group would benefit from more intensive PSA screening for earlier identification of cancer while it is potentially curable,” said Gerke. “This ‘smarter screening’ approach may allow us to identify and follow men at higher risk while reducing the population-wide harms of screening low-risk men.”