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Screening for prostate cancer with PSA test may be worth it for Black men

Screening for prostate cancer with the prostate specific antigen (PSA) blood test has favorable tradeoffs, particularly for Black men, according to a new study.

Previous calculations over a decade ago estimated that, at best, one death was prevented for every 23 men diagnosed with prostate cancer as a consequence of PSA screening. This suggested that too many men were experiencing the negative effects of a prostate cancer diagnosis compared to those who benefit for the PSA test to be recommended for all men.

Using epidemiologic data spanning a greater time period than previous estimates, the investigators from Weill Cornell Medicine and other medical centers produced new calculations of the number of men who were diagnosed and treated as a consequence of PSA screening as compared to the number of cancer deaths avoided.

For their calculations, the researchers improved on the previous estimates of overdiagnoses and overtreatment by including included 11 more years of data than prior estimates, calculating estimates for men of all races and Black men, and by using complementary approaches to estimating overdiagnosis.

The investigators estimated that for men of all races one death was prevented for every 11 to 14 men diagnosed with prostate cancer and every 7 to 11 men treated for the disease. However, for For Black men, screening resulted in one death prevented for every 8 to 12 men diagnosed, and every 5 to 9 men treated.

The new analysis supports the use PSA screening, particularly for Black men and others at high risk, the authors wrote.